Silo surgery, also known as staged abdominal closure, is a procedure where a surgeon uses a bag (silo) to gradually allow swollen intestines to return to the abdominal cavity.
Often performed on infants born with abdominal wall defects such as gastroschisis or omphalocele, silo surgery addresses the problem where the intestines, due to swelling, are too large to fit back into the abdomen immediately after birth. Here's a breakdown of the process:
- The Silo: The intestines are placed inside a sterile, transparent bag (the silo) that is attached to the infant's abdomen.
- Decompression: Over several days, the intestines gradually decompress as fluid is reabsorbed, reducing their size.
- Gravity-Assisted Reduction: Gravity and abdominal pressure help the intestines slowly return into the abdominal cavity. The silo is gradually reduced in size, encouraging the intestines to descend.
- Closure: Once the intestines are fully within the abdomen, the abdominal wall can be surgically closed.
Why is Silo Surgery Necessary?
Directly closing the abdomen when the intestines are too swollen can lead to increased intra-abdominal pressure. This can compromise blood flow to the intestines and other organs, leading to serious complications, including:
- Breathing difficulties
- Kidney failure
- Compromised blood supply to the bowel.
In Summary:
Silo surgery is a staged approach to abdominal closure, predominantly used in newborns with abdominal wall defects, that allows the intestines to gradually return to the abdominal cavity, mitigating the risks associated with immediate closure under high pressure.
