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Pediatric surgery

Pediatric Surgery

The term pediatric surgery refers to the surgical care of birth defects and other serious diseases a child may have after birth. These interventions are hosted by children’s hospitals and very commonly require novel techniques and methods nowadays widely available worldwide.

Pediatric surgery involves the treatment of:

  • Fetuses
  • Infants
  • Children
  • Adolescents
  • Young adults

Some areas of this surgical field require further training in pediatric sub-specialties during residencies and fellowships.

  • Pediatric cardiac surgery – relates to surgery in children’s heart and lungs including their transplants as well.
  • Pediatric nephrological surgery – includes kidney and ureter treatment in children and kidney transplantation.
  • Pediatric neurosurgery – refers to treating children’s brain, central nervous system, spinal cord and peripheral nerves.
  • Pediatric urological surgery – refers to the operation of the urinary bladder and the structures below the kidneys that are necessary for ejaculation
  • Pediatric emergency surgery
  • Pediatric hepatological and gastrointestinal surgery – comprises of treating liver, stomach and intestine conditions.
  • Pediatric orthopedic surgery – it involves muscle and bone surgeries.
  • Pediatric plastic surgery –  typically can be labeled as reconstructive surgery, for addressing burns and congenital defects such as cleft palate
  • Pediatric oncological surgery – deals with all class of childhood cancers.

Pediatric Surgery – Some Common Conditions Treated

There are a large number of pediatric diseases that require pediatric surgery.

The most often operated congenital malformations are:

  • lymphangioma
  • cleft lip and palate
  • esophageal atresia and tracheoesophageal fistula
  • hypertrophic pyloric stenosis
  • intestinal atresia
  • necrotizing enterocolitis
  • meconium plugs
  • Hirschsprung’s disease
  • imperforate anus
  • undescended testes

Among the abdominal wall defects we find:

  • omphalocele
  • gastroschisis
  • hernias

The most frequent chest wall deformities treated with pediatric surgery include pectus excavatum.

Childhood tumors include:

  • neuroblastoma
  • Wilms’ tumor
  • rhabdomyosarcoma
  • ATRT
  • liver tumors
  • teratomas

Pediatric Cardiac Surgery

There are many kinds of congenital heart defects, which can occur in the heart or in the large blood vessels surrounding it. Some defects may require surgery after birth, while some others may wait for months or years.

There are three techniques for fixing congenital heart diseases:

  • Open surgery, using a heart-lung bypass machine
  • Thoracotomy or closed-heart surgery, using special instruments and a camera.
  • Inserting small tubes into the artery in the leg and passing them up to the heart.

Some symptoms of diseases requiring pediatric heart surgery include:

  • Blue skin, due to hypoxia (not enough oxygen)
  • Difficulty breathing
  • Arrhythmia (problems with the heart rate)
  • Poor sleeping or feeding
  • Slow growth and development

Pediatric Plastic Surgery

The procedure is mostly conducted for reconstructive and cosmetic purposes, a blurred line in children, because congenital deformities impair aesthetics as well as function. Developmental abnormalities, trauma, infection, tumors are treated with pediatric plastic surgery to help regain normal motor function or to prevent future and current health problems.

The most common congenital birth defects treated by pediatric plastic surgeons and multi-disciplinary backup teams include:

  • Cleft lip
  • Syndactyly
  • Positional Plagiocephaly
  • Craniosynostosis
  • Head and neck tumors
  • Craniofacial abnormalities
  • Vascular abnormalities

Some surgeries performed for cosmetic purposes in children are:

  • Male breast reduction
  • Ear surgery for microtia
  • Rhinoplasy

Pediatric Orthopedic Surgery

This surgical sub-specialty refers to all surgical procedures of orthopedic conditions in children, including developmental disorders, congenital, neuromuscular and post-traumatic problems of the musculoskeletal system. Furthermore, rehabilitation, physical and occupational services and the use of orthotic and prosthetic devices are also included in pediatric orthopedic surgery.

The major areas of focus are:

  • Foot and hip development problems – club foot and hip dysplasia
  • Lower extremity deformities – knock knees, bow-leggedness, and rotational problems
  • Upper extremity deformities – congenital or developmental
  • Leg length discrepancy
  • Benign and malignant tumors
  • Fractures and other trauma to the extremities and spine
  • Cerebral palsy
  • Limb salvage
  • Radiofrequency ablation of osteoid osteomas

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