WOFAPS 2025 8th World Congress of Pediatric Surgery

Aim: In gastroschisis, primary closure is not possible in the presence of large diameter of the defect, meconium-stained and edematous bowel loops; therefore the silo method is used. Access and cost of industrial materials used for silos are problems. Here, we propose a method that is simple, inexpensive and can be applied in every hospital.

Method and Results: After the patient is taken to the neonatal care unit postnatally, a nasogastric and bladder catheter is inserted. At bedside the diameter of the gastroschisis defect is measured. The 0.9% NACI solution bag is opened sterile and the lower edge of the bag is cut in the sterile area. After the connector of the intubation tube appropriate for the baby's birth week is removed, a circle shape is made with a diameter 1 cm wider than the measured defect diameter. The circular tube prepared on the lower edge of the serum bag is inverted to the inner surface of the bag and continuously sutured with 2/0 silk. Since the intubation tube tends to return to a straight position due to its structure, sufficient tension is provided under the bag. The organs are placed at the bedside into the prepared silo, and the circular tube at the lower border of the bag is placed into the abdomen with the help of a Farabeuf retractor. The upper end of the bag is hung on the bed. Daily, the bag is rubbed from top to bottom and wrapped with tape.

Two patients with large defects and meconium staining were followed up without any problems with Silo. On the 4th postnatal day, the entire intestine was placed in the abdomen and both patients were discharged without complications after surgical gastroschisis repair.

Conclusion: This method we use is applicable because it is cheap, simple and effective.