"Minimal intervention management" for gastroschisis: a preliminary report

The replacement of eviscerated bowel, without anaesthesia, has been performed safely in stable neonates with gastroschisis. This technique, termed "minimal intervention management", was used in three infants treated at the Newborn Special Care Nursery of the University Hospital of the West Indies. Two infants had excellent results but one had bowel perforation during the procedure, necessitating conversion to formal laparotomy under general anaesthesia. In selected patients, advantages of this technique include the ability to be guided by patient response during the procedure in order to avoid excessive intra-abdominal tension, the avoidance of anaesthesia and minimal cost. This technique is proposed for wider use in developing countries.