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Pediatric Surgery

Pediatric Surgery

Counseling for Prenatally detected anomalies

During pregnancy ultrasound will be done to assess the growth of fetus in general and also development of individual organs.

In most cases, the scan will show that the baby appears to be developing normally, but sometimes the Fetal medicine sonologist will find or suspect a defect in the normal development of organs. Not all defects can be detected in prenatal scan. Some defects can be seen more clearly than others (Spina Bifida, Anencephaly, hydrocephalus, Cleft lip, Cleft palate, abdominal defects). Some defects like related to heart development may not be seen.

Some defects can be managed after delivery, some are not amenable to treatment and the baby who is unlikely to survive may warrant termination of pregnancy . The pregnant ladies with fetal defects (anomalies or abnormalities) will be referred to Pediatric surgeon for opinion regarding :-

  • a. Continuation of pregnancy
  • b. Need for regular visits
  • c. Place of delivery (need for specialized centres)
  • d. Timing of delivery (normal or induced before term)
  • e. Mode of delivery (normal delivery or cesarian section)
  • f. Evaluation after birth
  • g. Timing of surgery ( immediate or elective)

Common defects detected in prenatal ultrasound are

  • a. Nervous System defects (anencephaly, encepalocele, meningocele, meningomyelocele, hydrocephalus)
  • b. Neck abnormalities (cystic hygroma, Cervical teratoma)
  • c. Lung anomalies (CCAM, CLE, sequestrations, CDH)
  • d. Abdominal wall defects (Omphalocele, gastrochisis, Extrophy bladder, Cloacal extrophy)
  • e. Echogenic bowel
  • f. Cysts and solid lesions in abdomen (Omental, Mesenteric cysts, Ovarian cysts, Neuroblastoma)
  • g. Dilated urinary systems (Hydronephrosis, Bladder outlet obstruction due to PUV)
  • h. Sacral lesions (Sacrococcygeal teratoma)
Surgeries for Birth Defects (Congenital Anomalies)
  • a. Esophageal atresia (with or without Tracheoesophageal fistula)
  • b. CCAM
  • c. CLE
  • d. CDH
  • e. CDE
  • f. Duplication cysts
  • g. Cysts in abdomen
  • h. Duodenal or intestinal atresias
  • i. Malrotation
  • j. Meconium ileus
  • k. Anorectal malformations
  • l. Hirschprungs disease
  • m. Encephalocele
  • n. Spina bifida
  • o. Posterior Urethral valves
  • p. Hydronephrosis
  • q. Omphalocele
  • r. Gastroschisis
  • s. Extrophy bladder
  • t. Cloacal extrophy
  • u. Hypospadias
  • v. Epispadias
  • w. Sacrococcygeal teratoma
Head and Neck Surgeries
  • a. Brachial cysts and Sinus
  • b. Thyroglossal cysts
  • c. Dermoid and sebaceous cysts
  • d. Lymphatic malformations
  • e. Lymphnode biopsy
Pediatric Surgical Gastroenterology
  • a. Infantile hypertrophic pyeloric stenosis
  • b. Gastroesophageal reflux disorder
  • c. Duplication cysts
  • d. Anorectal malformations
  • e. Hirschprungs disease
  • f. Biliary atresia
  • g. Choledochal cysts
  • h. Nesidoblastosis requiring pancreatic resection
  • i. Liver abscess drainage
  • j. Persistant vitello intestinal duct
  • k. Inguinal hernias
  • l. Umbilical hernias
  • m. Congenital hydrocele
Pediatric Hepatobiliary Surgeries
Pediatric Urology
  • a. Uretero-pelvic junction obstruction
  • b. Uretero-vesical junction obstruction
  • c. Posterior urethral valves
  • d. Vesico-ureteric reflux
  • e. Neurogenic bladder
  • f. Undescended testis
  • g. Circumcision for Phimosis.
Pediatric Thoracic Surgery
  • a. Lung Resections for CCAM, CLE
  • b. Sequestration cysts
  • c. Bronchogenic cysts
  • d. VATS for Empyema
  • e. Decortications for Empyema
  • f. Lung Biopsy
  • g. Duplication cysts
  • h. Mediastinal lesions
Pediatric Neurosurgery
  • a. Hydrocephalus
  • b. Encephalocele
  • c. Spina bifida
Pediatric Surgical Oncology
  • a. Wilms tumor
  • b. Neuroblastoma
  • c. Hepatoblastoma
  • d. Lymphoma
  • e. Rhabdomyosarcoma
  • f. Soft tissue sarcoma
  • g. Testicular tumors
  • h. Ovarian tumors
  • i. Biopsy for suspected malignancy
  • j. Pheochromocytoma
  • k. Sacrococcygeal teratoma
Surgeries for Birth stains/marks
  • a. Hemangiomas
  • b. Vascular malformations
  • c. Lymphatic malformationsa
Surgeries for Genital abnormalities
  • a. Hypospadias
  • b. Epispadias
  • c. Intersex disorder
  • d. Cryptorchidism
Neonatal Surgical Emergencies
  • a. Necrotizing enterocolitis
  • b. Neonatal intestinal obstruction
  • c. Volvulus of intestine
Pediatric Surgical Emergencies
  • a. Infantile hypertrophic pyeloric stenosis
  • b. Appendicitis
  • c. Meckels diverticulitis
  • d. Intestinal obstruction
  • e. Intussusception
  • f. Torsion testis
Pediatric Trauma Services
  • a. Lacerations
  • b. Blunt abdominal trauma
  • c. Penetrating abdominal trauma
  • d. Blunt thoracic trauma
  • e. Penetrating thoracic trauma
Minimal Access Surgery
  • a. Nissen fundoplication
  • b. Splenectomy
  • c. Appendectomy
  • d. Diagnostic Laparoscopy
  • e. Pyeloplasty
  • f. Pyloromyotomy
  • g. Choledochal cyst excision
  • h. Thoracoscopic proceduresa. Lacerations

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