PVID Excision

PVID excision surgery

PVID excision surgery is a minor urologic surgical procedure that removes redundant, invaginated, or adherent ventral penile tissue, which may cause:

• Painful erections
• Recurrent infection from the trapped moisture
• Cosmetic deformity
• Pain with intercourse
• Functional problems of skin mobility

This procedure is often performed in adults, sometimes in adolescents, who have stable anatomy.

Indications for PVID excision

Your doctor may recommend this procedure for you if you have:

• Penile vestibular invagination deformity
• Redundant ventral skin after circumcision
• Scar tissue or skin bridges
• Difficulty retracting skin over the glans
• Pain or pulling sensation during erection

Patent vitellointestinal duct excision procedure

• A vitellointestinal duct connects the fetal intestine to the umbilical cord during embryonic development.
• It usually disappears by the 7th–9th week of gestation.

When it remains open, known as patent, it forms a tubular connection between the ileum and the umbilicus, leading to:

• Fecal discharge from the umbilicus
• Infection of the umbilical stump or persistent umbilical infection
• Umbilical prolapse (ileal mucosa protruding)
• Irritation, possibly infection of skin around the umbilicus
• Surgical intervention is the definitive treatment.

PVID Excision Surgery: A Step-by-Step Procedure

Preoperative Preparation

• General anaesthesia
• Blood tests, abdominal ultrasound
• Bowel preparation, if needed
• IV antibiotics started before surgery

Surgical Steps

Step 1: Incision

• A circum-umbilical or infra-umbilical incision is made
• The duct is exposed by elevating the umbilicus.

Step 2: Identification of the Duct

• The patent duct is traced from the umbilicus to the ileum.

Surgeons evaluate:

• Length
• Width
• Associated anomalies: Meckel’s diverticulum, fistula, sinus

Step 3: Excision of the Duct

• The entire duct is carefully separated from surrounding tissues.
• Complete excision is done to prevent recurrence.

Step 4: Ileal Repair

Depending on the duct attachment, surgeons may perform:

• Simple Ligation & Closure

If the duct is narrow, and only a small attachment is formed:

• Divide the duct from the ileum
• Close ileal defect with absorbable sutures (single or double layer)
• Segmental Bowel Resection-if needed

If the duct is:

• Wide
• Has inflammation
• Associated with Meckel’s diverticulum
• Involves a large ileal segment

Then:

• A short segment of ileum is resected.
• End-to-end bowel anastomosis is performed.

Step 5: Umbilical Reconstruction

• Umbilicus is reconstructed for normal appearance
• Skin is sutured with fine absorbable stitches

Completion of Procedure

• Hemostasis ensured
• Sterile dressing applied

• Infant/child moved to recovery

Recovery after PVID Excision

Hospital Stay:

• Typically 2–4 days
• Longer if bowel resection or complications occur

Postoperative Care:

• IV fluids and antibiotics
• Pain management
• Gradual switch to oral feeds
• Wound care to keep the umbilical area clean

PVID excision treatment

Diagnosis before Treatment

Doctors confirm PVID through:

• Physical examination of the umbilicus
• Ultrasound abdomen
• Sinogram/fistulogram (in selected cases)
• Blood tests
• Assessment for Meckel’s diverticulum

Treatment for PVID

There is only one effective treatment:

Surgical excision of the patent vitellointestinal duct

Since the duct opens into the intestine directly, it cannot close by itself, and thus, surgery is needed to prevent the following:

• Infection
• Bowel obstruction
• Skin breakdown
• Severe complications include volvulus.

Types of PVID Excision Treatment:

Simple PVID Excision

Used when the duct is:

• Narrow
• Short
• Not involving significant bowel tissue

Procedure Includes:

• Duct removal
• Closure of the opening in the ileum (single/double layer sutures)
• Reconstructing the umbilicus

PVID Excision with Ileal Resection

Required when:

• Duct is wide
• Tissue is inflamed
• Meckel's diverticulum is present.
• The intestinal attachment is large.

Procedure Includes:

• Excising the duct along with a short segment of ileum
• Performing end-to-end bowel anastomosis
• Umbilical reconstruction

Laparoscopic PVID Excision - Minimally Invasive

In selected cases, especially in older children:

• 2–3 small incisions
• Duct is traced and removed
• Bowel repaired laparoscopically
• Faster recovery and less scarring

Surgical removal of PVID

The surgery is performed with general anaesthesia and generally takes 45–90 minutes, based on complexity.

Step-by-Step Surgical Procedure

Incision

• A small circum-umbilical or infra-umbilical incision is made.
• Gently retract the umbilicus to expose the abnormal duct.

Identification of the Duct

• He then traces the duct from the umbilicus to the small intestine, or ileum.
• Any associated anomalies, such as Meckel’s diverticulum are evaluated.

Excision of the Duct

• The entire vitellointestinal duct is carefully separated from surrounding tissues.
• The duct is completely removed to prevent recurrence.

Intestinal Repair

Depending on how the duct is attached to the intestine:

Simple Closure (Most Common)

Used when the duct is narrow and attached by a small opening:

• The duct is subdivided near the ileum.
• The small opening in the ileum is closed with fine absorbable sutures.

Bowel Resection and Anastomosis-if required

Used when:

• The duct is wide.
• Does intestinal mucosa
• There is infection or inflammation
• A Meckel’s diverticulum is present

In this case:

• A small portion of ileum is removed (resected).
• Both ends of the intestine are sewn back together.

Umbilical Reconstruction

• The umbilicus is reshaped and sutured in place carefully to ensure an excellent cosmetic result.

Dressing

• A sterile dressing is applied to protect the wound.

Surgical Approaches - Types

Open PVID Resection (Traditional Approach):

• Small open incision at the umbilicus 
• Suitable for newborns and infants 
• Excellent results 

Laparoscopic PVID Removal:

• 2–3 small keyhole incisions 
• Faster healing, less scarring 
• More commonly used in older children 

Factors Affecting PVID excision cost India

The cost for PVID surgical excision in India depends on several factors that determine the final cost of treatment:

Complexity of the Case 

• If the duct is narrow and can be excised with simple closure of the intestine → lower cost. 
• And if there is associated bowel resection, infection, or complications → more cost: longer operating time, higher risk, more resources. 
• More complex procedures require longer theatre time, more consumables, possibly ICU stay. 

Type of hospital and infrastructure 

• Major multispecialty hospitals or tertiary care centers charge more compared to smaller hospitals. 
• Private versus public/government hospitals: private tends to be more expensive. 
• Facilities like ICU, specialized paediatric surgery, advanced diagnostics will raise cost. 

Geographic Location 

• Hospitals in metro cities, for example- Delhi, Mumbai, Bangalore, are usually costlier owing to a higher operating cost of living, staffing, etc. 

Surgeon & Team Expertise 

• Highly experienced pediatric surgeons or specialty centers may charge higher fees. 
• If the procedure requires specialist support-anaesthesiologist, neonatal/pediatric ICU, the cost rises. 

Pre-operative Workup & Investigations 

• Additional cost is added by pre-op imaging, labs, possible bowel preparation, and specialist consultation. 
• If there are added diagnostics due to complications, then the cost increases accordingly. 

Postoperative Care & Hospital Stay Duration 

• Longer stay (due to complications or bowel resection) raises the room charges, nursing charges, medicines. 
• Use of the ICU, ventilation, and advanced monitoring add significantly. 

Consumables, Medications & Implants (if any) 

• Although the surgical excision of PVID may not involve implants, any special consumables, advanced sutures, and laparoscopy equipment, or imported devices will raise the cost. 
• Also, the inflation of medical consumable costs contributes. 

Anaesthesia & Operating Theatre Time 

• The longer the surgery, the higher the cost for OT time, anaesthesia, staff. 
• Complex cases require more in theatre and monitoring. 

Hospital Stay & Room Category 

• Private room vs. shared ward: significant difference. 
• Where the patient stays longer than average or chooses premium room, the cost goes up. 

Timing-Elective vs. Emergency 

• If done emergently due to complications, the cost tends to be higher on account of urgency and extra monitoring. 
• Advance planning and admission often offers cost savings.

PVID excision recovery time

Here is a clear, accurate, and patient-friendly overview of recovery time after PVID (Patent Vitellointestinal Duct) excision. Recovery varies based on whether it was a simple excision or required bowel resection, but most children recover fast.

PVID Excision Recovery Time

Hospital Stay:

Simple PVID Excision

• 2–4 days in hospital

PVID Excision + Bowel Resection

• 4–6 days in hospital

Sometimes slightly longer if bowel inflammation was present

Timeline of Recovery After Surgery

Day 0 – Surgery Day

• Child kept under observation
• IV fluids and antibiotics are given
• Feeding orally can be initiated in the evening or the next day

Day 1–3

• Swelling and mild discomfort around the umbilicus
• Feeding gradually returns to normal
• Dressing intact
• Child can be carried and moved about easily
• Discharge often around Day 2–4 in simple cases

Week 1

• Most discomfort settles

• Healed well started umbilical wound

• Absorbable stitches do not require removal

• Follow-up visit usually advised after 5–7 days

Week 2–3

• Wound fully dry
• Child resumes most normal activities
• Avoid heavy strain, rough playing, or pressure on abdomen

Week 4–6

• Complete recovery in the majority of children
• Umbilicus shape forms normally
• Internal healing of bowel repair completes 

Conclusion

The surgical excision of PVID is an effective, safe, and important part of managing a patent vitellointestinal duct. Because the duct creates an abnormal connection between the small intestine and umbilicus, it cannot close spontaneously. Timely surgery prevents complications such as infection, bowel obstruction, and prolapse. The very vast majority of PVID cases-both the simple duct excision and the type requiring bowel resection-have an incredibly high success rate and excellent long-term outcome, restoring normal appearance to the umbilicus and intestinal function. Most children recover completely within 4-6 weeks with proper postoperative care, returning to normal feeding, activity, and growth. The best results are achieved by early diagnosis and intervention, which minimizes further complications. 

PVID excision surgery India GetWellGo

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We offer:

Complete transparency

• Fair costs.
• 24 hour availability.
• Medical E-visas
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• Assistance in selecting India's top hospitals for PVID excision treatment.
• Expert general surgeon with a strong track record of success
• Assistance during and after the course of treatment.
• Language Support
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• Case manager assigned to every patient to provide seamless support in and out of the hospital like appointment booking
• Local SIM Cards
• Currency Exchange
• Arranging Patient’s local food

FAQ

1, Is surgery necessary for PVID? 

• It cannot close on its own. Yes, surgery is the only treatment effective in preventing serious complications related to infection, obstruction, or bowel prolapse. 

2. At what age is PVID excision performed? 

• Once the diagnosis has been confirmed, it is usually corrected surgically either during infancy or early childhood. The best results are obtained with early correction. 

3. After the surgery, will the child have a normal-looking belly button? 

• Yes, the surgeons reconstruct the umbilicus to maintain a natural look during the procedure. 

4. Are stitches removed after surgery? 

• Usually no, most stitches are dissolvable and fall out on their own. 

5. What is the long-term outlook after PVID excision? 

• Excellent; all children grow normally with no dietary restrictions in the long term and hardly any future problems once the surgery is performed.