 The initial operation immediately after birth provides separation of the peritoneal and pericardial cavities, coverage of the midline defect and repair of the omphalocele.After appropriate growth of the thoracic cavity and lungs, the second stage consists of the repair of cardiac defects and return of the heart to the chest.Eventually, usually by age 2 or 3, reconstruction of the lower sternum or epigastrium may be necessary.