Paediatric surgery
Pediatric surgery refers to surgical procedures performed on children from infancy to adolescence. Pediatric surgeons are specially trained to address the unique needs of children, as their anatomy, physiology, and response to surgery differ significantly from adults. Pediatric surgery covers a wide range of conditions, including congenital abnormalities, trauma, infections, and pediatric cancers.
Here’s a breakdown of the common types of surgeries under pediatric surgery:
Congenital Abnormalities
Many pediatric surgical procedures address birth defects or abnormalities that children are born with. These can involve various systems, including the gastrointestinal, cardiovascular, and musculoskeletal systems.
- Cleft Lip and Palate Repair: Surgery to repair congenital cleft lips or palates, which are openings or splits in the upper lip or roof of the mouth.
- Gastroschisis and Omphalocele Repair: Surgical closure of openings in the abdominal wall through which intestines or other organs protrude at birth.
- Hypospadias Repair: A surgery to correct hypospadias, a condition where the opening of the urethra is not at the tip of the penis.
- Pyloromyotomy: A procedure to treat pyloric stenosis, a condition in infants where the pyloric muscle becomes thickened, blocking food from entering the small intestine.
- Exstrophy of the Bladder Repair: Surgical correction of a rare condition where the bladder is exposed on the outside of the body at birth.
- Imperforate Anus Repair: Surgical procedure to correct a congenital condition where the anus is malformed or absent.
- Tracheoesophageal Fistula (TEF) and Esophageal Atresia Repair: Surgery to treat abnormalities where the esophagus and trachea are abnormally connected, preventing normal swallowing and breathing.
Gastrointestinal (GI) Surgeries
Pediatric gastrointestinal conditions are common, and many surgeries address issues related to the stomach, intestines, liver, and pancreas.
- Appendectomy: Removal of the appendix, typically performed when a child has acute appendicitis.
- Inguinal Hernia Repair: Surgery to repair a hernia in the groin, often performed in infants or young children.
- Intestinal Obstruction Surgery: Surgery to remove blockages in the intestines, which can result from conditions like volvulus (twisting of the intestines) or intestinal atresia (narrowing or absence of part of the intestine).
- Meckel’s Diverticulum Surgery: Removal of a small pouch (diverticulum) in the small intestine that is present at birth and can lead to complications like bleeding or infection.
- Colostomy and Ileostomy: Creation of an opening in the abdomen to allow waste to leave the body when the colon or intestines are not functioning properly. This is sometimes necessary for intestinal malformations or after colon resection.
- Liver Surgery: Surgery to remove portions of the liver for conditions like liver tumors (e.g., hepatoblastoma), or to address biliary atresia (a condition where bile ducts are blocked or absent).
Cardiothoracic Surgery
Pediatric cardiothoracic surgery deals with heart and lung conditions that are congenital or acquired.
- Congenital Heart Defect Surgery: Surgical procedures to correct heart defects present at birth, such as:
- Atrial Septal Defect (ASD) Repair: Closing a hole between the heart’s upper chambers (atria).
- Ventricular Septal Defect (VSD) Repair: Closing a hole between the heart’s lower chambers (ventricles).
- Tetralogy of Fallot Repair: Surgery to correct a combination of four heart defects that affect normal blood flow.
- Patent Ductus Arteriosus (PDA) Ligation: Closing the ductus arteriosus, a vessel that should close shortly after birth but remains open in some babies.
- Coarctation of the Aorta Repair: Surgery to remove narrowing in the aorta, which can obstruct blood flow.
- Congenital Diaphragmatic Hernia Repair: Surgery to repair a defect in the diaphragm, which allows abdominal organs to move into the chest cavity, often affecting lung development.
- Heart Transplant: In severe cases of heart failure, a pediatric heart transplant may be necessary.
Urological Surgery
Pediatric urology deals with conditions affecting the urinary and genital systems.
- Circumcision: A procedure to remove the foreskin from the penis, which may be done for medical or cultural reasons.
- Hydrocele Repair: Surgery to treat a hydrocele, a fluid-filled sac around the testicle, common in newborns.
- Orchiopexy: Surgery to reposition undescended testicles into the scrotum.
- Vesicoureteral Reflux (VUR) Surgery: Surgery to correct the backward flow of urine from the bladder into the kidneys, which can lead to kidney infections or damage.
- Nephrectomy: Removal of a kidney, often for conditions like Wilms’ tumor, a type of kidney cancer that typically affects children.
- Bladder Augmentation: A procedure to increase the size of the bladder, often done for children with small or nonfunctional bladders.
Orthopedic Surgery
Pediatric orthopedic surgery focuses on musculoskeletal issues in growing children.
- Clubfoot Surgery: Surgery to correct clubfoot, a condition where a baby’s foot is turned inward and downward.
- Hip Surgery for Developmental Dysplasia: Procedures to treat hip dysplasia, a condition where the hip joint is improperly formed in infants or children.
- Scoliosis Surgery: Surgical correction of scoliosis, a sideways curvature of the spine, often performed when the curvature is severe.
- Fracture Repair: Surgical intervention to treat fractures that are not healing properly or are displaced in children.
- Leg Lengthening: Surgery to treat conditions where a child’s limbs are of unequal length, such as due to injury or congenital conditions.
Neurosurgery
Pediatric neurosurgery involves the treatment of conditions related to the brain, spine, and nervous system.
- Hydrocephalus Shunt Insertion: Surgery to insert a shunt to drain excess cerebrospinal fluid from the brain, often performed in cases of hydrocephalus (fluid buildup in the brain).
- Spina Bifida Repair: Surgery to close the opening in the spine caused by spina bifida, a congenital defect of the spinal cord and vertebrae.
- Pediatric Brain Tumor Surgery: Removal of brain tumors in children, including gliomas, medulloblastomas, and ependymomas.
- Craniosynostosis Surgery: Surgery to correct craniosynostosis, a condition where the bones in a baby’s skull fuse too early, potentially leading to abnormal head shapes and developmental issues.
Trauma Surgery
Pediatric trauma surgery involves the treatment of injuries resulting from accidents, falls, or blunt force trauma.
- Fracture Repair: Surgery to stabilize and treat fractures in children, especially those that are complex or unstable.
- Laceration Repair: Surgical repair of deep cuts or tears in the skin or other tissues.
- Splenectomy: Removal of the spleen, typically in cases of severe trauma or rupture.
Oncological Surgery
Surgical oncology in children involves the treatment of pediatric cancers.
- Tumor Resection: Removal of solid tumors in children, such as those affecting the liver, kidneys, brain, or soft tissues (e.g., Wilms’ tumor, neuroblastoma, rhabdomyosarcoma).
- Bone Tumor Surgery: Removal of bone tumors like osteosarcoma or Ewing sarcoma.
- Retinoblastoma Surgery: In cases of retinoblastoma, a rare eye cancer, surgery may be performed to remove the affected eye or to treat the eye with lasers or cryotherapy.
Plastic and Reconstructive Surgery
Pediatric plastic surgeons treat congenital defects, injuries, and disfigurements.
- Craniofacial Surgery: Correction of craniofacial anomalies such as cleft lip, cleft palate, and craniosynostosis.
- Burn Reconstruction: Surgery to treat burn injuries and improve the appearance and function of the skin after burns.
Endoscopic and Minimally Invasive Surgery
Some pediatric surgeries are now performed with the assistance of minimally invasive techniques, which involve smaller incisions and faster recovery times.
- Laparoscopy: A minimally invasive procedure for abdominal surgeries like appendectomy, cholecystectomy, and hernia repair.
- Thoracoscopy: Minimally invasive surgery performed in the chest cavity to treat conditions like pneumothorax (collapsed lung) or mediastinal tumors.
Pediatric surgery encompasses a wide variety of procedures aimed at treating conditions specific to children, including congenital defects, injuries, cancers, and other diseases. Pediatric surgeons are trained to address these issues with techniques that are appropriate for a child’s smaller size, growing body, and unique physiological characteristics
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