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Pediatric Surgery

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Dr. Anoopkumar Bangroo
Consultant neonatal and pediatric surgeon
Pediatric Surgery

Children are not 'MINIATURE ADULTS', more so when they require surgical interventions. In the context, Pediatric Surgery is the speciality that provides holistic care to children with surgical problems, from newborns to adolescents. The need for this specialization stems from the fact that unlike adults, children require special care during illness because not only is their routine interrupted, but also their growth and development. As such, surgical interventions may have long-term implications unless managed appropriately. Additionally, certain developmental abnormalities, which may be associated with other organ defects, need to be detected, evaluated and managed even though they may not manifest clinically.

Parents are often apprehensive about their little ones tolerating surgery, anesthesia, and associated procedures, and therefore, postpone seeking advice. It is reassuring that in recent times, all operative procedures in children are supported by professionals capable of managing children e.g. pediatricians and neonatologists, anesthetists, nutritionists, physiotherapists etc.

A child’s growing body is a dynamic system. it reaches its milestones in a systematic or programmed manner. Disease manifestations are often a window into an erroneous program. Defects in this program need to be detected in time and resolved early. With children, it is always better early than sorry.

Pediatric Surgeons are adept in handling fine surgeries in babies. They are experts in managing the 'child with a surgical problem', and not just the 'surgical problem' in a child. Children requiring pediatric surgical consultation are not only those with obvious external structural defects, but also children with a lot of other internal structural and functional deficiencies. These may involve any organ from head to toe. Some of these deficiencies could have been picked up by antenatal sonography, and they need counseling and planned evaluation after delivery to prevent any loss of structure or function of the organs involved. Very few hospitals have full-time pediatric surgical expertise available round the clock, as also the necessary infrastructure to investigate and manage/operate on precious little children.

In Kiran Hospital the Department of Pediatric Surgery is run on full time basis and the services offered are:

  • Reconstructive and reparative pediatric urology
  • Neonatal surgeries
  • Minimally invasive surgeries or keyhole surgeries of the abdomen(laparoscopy) and chest (thoracoscopy)
  • Endoscopic procedures of windpipe (bronchoscopy), food pipe (esophagoscopy) and urinary tract (cystoscopy, etc)

Pediatric Urology

Urological problems in children are the commonest and may manifest as urinary infections, persistent bed wetting, urgency or frequency of urination, dribbling of urine, poor, urinary stream, absence of testis from the scrotum, swelling in the groin, ballooning or non retractable foreskin of the penis, abnormally placed external urinary opening, ambiguous genitalia, etc. These children require special tests for evaluating their urinary tract like dye studies of the kidneys and bladder, bladder function studies like urodynamics and endoscopy. Pediatric surgeons here themselves supervise/perform these tests done.

Some of the pediatric urological procedures include:

  • Pyeloplasty for hydronephrosis (Enlarged kidney due to block)
  • Endourological ablation of posterior urethral valves
  • Treatment of vesico ureteric reflux (Urine refluxing back from bladder)
  • Neurogenic bladder management
  • Laparoscopic treatment of undescended testes
  • Urethroplasty for hypospadias (abnormally sited external urinary opening)
  • Circumcision for phimosis
  • Complex urological procedures like augmentation cystoplasty (surgically increasing bladder capacity)
Pediatric Airway and thoracic procedures:
  • These include endoscopic removal of ingested or aspirated foreign bodies, which is a common emergency in toddlers and little children who generally tend to put small objects in their mouth/nose, and then choke on them.
  • Other surgeries include minimally invasive surgery (thoracoscopy) and surgery for structural airway and lung problems like Empyema, Lobar Emphysema, and Congenital Cystic Adenomatoid Malformation etc.
Minimally invasive surgeries:
  • keeping with the trend of minimally invasive surgery the department has made rapid strides in laparoscopic surgery. The procedures done are appendicectomy, cholecystectomy, orchidopexy, and diagnostic laparoscopy. These techniques have lead to significant reduction in the size of incision, post op. pain, hospital stay and complications.
Pediatric gastrointestinal, hepatobiliary and pancreatic obstructions
  • Diseases include pancreatitis, Congenital Obstructive diseases of the gastro intestinal tract and jaundice due to obstruction of the bile ducts. Surgeries are perfumed for removing these obstructions.
Solid Cancers in children
  • Unlike in adults, these conditions are generally curable in children. Some of these are Nephroblastoma, (cancer of the kidney), Neuroblastoma, Hepatoblastoma (cancer of the liver), Rhabdomyosarcoma, Germ cell tumors etc.
Day Care Surgeries
  • Several common surgeries, which earlier required hospitalization, are now done as 'Day-care surgeries' where patients are admitted and discharged on the same day. These include circumcision, surgeries for hernias, hydrocele, undescended testes, etc
Area Of Interest
  • Single stage surgeries instead of traditional multistage procedures for anorectal malformations and hirschsprung's disease as stated above and laparoscopy.