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The umbilicus was preserved in 32 gastroschisis repairs. A modified technique was performed in the last eight infants, which provided an improved cosmetic appearance. The procedure is suitable for both primary and staged repairs.

Seventeen infants with a very low birth weight (VLBW) and spontaneous, non-necrotizing enterocolitis (NEC), intestinal perforations are presented; 14 of them were seen in the past 3 years. A comparison with 16 surgically treated NEC infants (< 1,000 g) is provided. At our institution, the yearly survival of VLBW infants increased from 54% to 90% over the past 6 years. All 17 non-NEC patients were operated on, and 15 (88.2%) survived. Ileal perforations were observed frequently. Initial enterostomies were followed by reanastomosis at an average age of 3 months. A 22.6-month follow-up was attained for all survivors. Non-NEC intestinal perforations in tiny neonates are increasing and constitute a challenging but treatable group. The improving survival rate of VLBW infants will probably be accompanied by a variety of complications.

A newborn with a large omphalocele is presented. A new technique of umbilical preservation is introduced. The cosmetic result was excellent, and the method is suitable for both primary and staged omphalocele repairs.

One hundred eight consecutive bilateral inguinal herniorrhaphies were performed in female infants and children over the past 56 months. A technique that uses a single suprapubic incision is described. The average age was 29.8 months. The operative time was decreased by 5.6 minutes, and the final results were excellent.

Catheter decompression of the bilioenteric conduit was routinely carried out coincident with stomal closure in 15 consecutive patients with biliary atresia after Kasai hepatic portoenterostomy operation. Postoperatively the catheter was systematically, gradually occluded over a 3- to 8-week period and then withdrawn. Complications were relatively minor and early postoperative cholangitis was avoided.