When surgery happens

Educational, not medical advice. If you have an urgent concern, call your physician or 911.

Module 4 — Surgery and Recovery · Episode 14

Timing follows stability

CDH repair is timed to the baby’s condition, not the calendar. The team waits until breathing and circulation are stable enough to tolerate an operation, which is usually a few days after birth. Operating too early, on an unstable baby, is riskier than waiting.

The operation

The surgeon returns the abdominal organs to the belly and closes the opening in the diaphragm. The approach (through the abdomen or the chest, open or minimally invasive) depends on the baby’s anatomy and condition, with open repair often preferred for larger defects.

The exception: repair on ECMO

If a baby is on ECMO and cannot be weaned, repair may be done while on the machine. At Texas Children’s, that repair is generally performed early, within about 24 hours of starting ECMO, as discussed in the ECMO episode.

What you will hear afterward

The surgeon will describe the size of the defect and whether a patch was needed, which the next episode explains and which has implications for recovery and follow-up.

Next in Module 4: Patch repairs explained · Back to Module 4