Giant Omphalocele

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Abstract
THE OPERATION devised by Gross, in 1948, has made it possible to save the lives of many infants with enormous omphaloceles, in whom a primary closure of the abdominal wall in all of its layers is out of the question. Pointing out that forceful approximation of the widely separated recti resulted in intolerable increase in intra-abdominal pressure and abrupt elevation of the diaphragms to the point of fatal respiratory embarrassment, Gross1suggested wide undermining of the abdominal skin, which was then drawn over the intact amniotic membrane of the omphalocele. A large ventral hernia was thus produced, and in most children the coelom, in the course of succeeding months, enlarged to accommodate the displaced viscera, sometimes aided by gradual compression with a binder. However, it has not always been easy, in the patients with the larger omphaloceles, to complete the closure of the abdominal wall at a second stage,

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