Surgery for Children is not the same as in an Adult- “Children are not small adults”. Their anatomy and physiology is different and evolving. They need a tailored individualized approach. Pediatric Surgeons are trained initially in General Surgery and under go another further three years of training in surgical diseases of children. They are trained to operate children from the newborn period to adolescence. They are trained to adapt to the growing child and their changing needs. Pediatric surgeon treats children with severe congenital birth defects to complex surgical problems rarely seen in adults.
The surgical treatment of a child requires patience and understanding of families from whom having a child with a birth defect may be devastating. Most birth defects can be corrected with a reasonable long term survival and prognosis. Complex anatomical defects may need to be reconstructed in stages. Some common birth defects are the absence of anus, absence of food pipe, bowel in the chest, loss of continuity of bowel, defects of abdominal wall, antenatal hydronephrosis. They require initial treatment in the neonatal age with some requiring further surgery after a few months.
Children also may face certain conditions which are unique to childhood such as intussusceptions, certain malignancies. Some children have complex congenital problems which require close follow up and long term management.
Our Pediatrics Services
This surgery done in a child, who is less than one month old. They usually undergo emergency procedures and occasionally some elective surgeries. Some of the emergency surgeries done are for absent anus ( Anorectal malformation), disconnected food pipe ( trachea esophageal fistula with esophageal atresia), bowel in the chest due a gap in the muscle between the chest and abdomen (Congenital Diaphragmatic Hernia), blocked small bowel causing abdominal distention, yellow vomiting, a child who is unable to pass urine properly.
Elective surgeries are planned surgeries done in a new born child. Inguinal hernia is swelling seen in the groin of the child especially when the child cries or strains. It reduces when the child is sleeping. Surgery is required in the newborn period because there is a higher risk of complications in them such as obstruction of the small intestine requiring emergency surgery.
Pediatric Thoracic Surgery
This is surgery of the chest, for the lungs and esophagus. Some children with lung infection may develop fluid in the space between with lung and chest causing breathing difficulty. It is usually drained with a tube in the chest. Occasionally the lung is unable to expand because it is trapped by the infection, then the child may need surgery (Thoracoscopic or open) the free the lung.
In some children there may be bowel in the chest due to the absence of the muscle separating the chest and abdomen. Others may have abnormal swellings in the lung causing recurrent infections or difficulty in breathing.
Some children have some difficulty in passing at occasionally. The most common cause is urine infection, where the child has pain in passing urine along with fever. It is usually because of a tight foreskin in boys or poor toilet habit in girls. But some children have to be investigated because they may problems of the kidney, ureters or bladder, which if ignored can cause life threatening illness.
Some children have swelling of one kidney usually detected before birth. These children need to be investigated to check if the kidney is blocking the flow of urine. Some children may pass urine with great difficulty. This may be because of there is a problem with urethra (urine passage from the bladder). If it is not treated promptly some children may develop long term kidney problems.
Pediatric Continence Clinic
Continence is the control of bowel and bladder movements. A patient of toilet training age should be able hold their urine or bowel movement until they are able to empty their bowel or bladder in a bathroom. Some children do not get toilet trained. They continue to soil their undergarments. They may continue to bed wet well into their preteens and occasionally their teens. Children with abnormalities of the bowel or bladder at birth may not be able attain toilet training and they may need help in doing so. As pediatric surgeons and urologists we evaluate children for underlying problems and offer solutions to achieve dryness through either behavior therapy, medical or surgical treatment.
Pediatric Minimal Invasive surgery
This is also known as “Key Hole Surgery”. This is another approach in doing surgery where access to the area of interest in through small ports which minimize scarring and post operative pain. This is done with the use of fibro optic light systems and cameras. This allows access to difficult to reach areas with magnification. This approach allows complex surgeries to be done with minimal external scars.
Ultrasound scans can detect some birth defects before the baby is born. Some of these defects are non compatible with life. There are many birth defects that can be treated after birth. Some defects can be treated before birth. Birth defects such as swelling of the kidneys, bowel dilatation, bowel in the chest can be treated. Parents are counselled and given treatment options regarding the birth defect.