Pediatric Surgery

What is pediatric surgery? 

Pediatric surgery is the only surgical specialty that is defined by the age of the patient, rather than a specific condition, and encompasses the treatment of diseases, injuries, and malformations from birth to adulthood. It is therefore significantly different from other surgical specialties that deal with a specific area of ​​the body or a specific surgical technique.

Pediatric surgeons must be familiar with the broad physiological differences between each age group of patients from newborns to adults, be familiar with surgical conditions related to different age groups, and must possess specific skills for working with children and their families. Pediatric surgeons lead teams of health experts who provide the necessary services to diagnose, treat, and support children with surgical diseases of the chest (such as esophageal and lung anomalies), abdomen, urogenital tract, bone injuries, and injuries and diseases of the soft tissues of the trunk and limbs. They also perform surgeries that improve the quality of life of children with certain chronic conditions and difficulties in growth and development. Pediatric surgeons treat a very wide range of surgical acute and elective conditions and pediatric surgery can be divided into the following areas: neonatal surgery - congenital malformations of the digestive tract, lungs, abdominal wall and urogenital system are surgically treated. As part of prenatal counseling, pediatric surgeons, together with obstetricians and pediatricians, plan the care of the mother and child from birth to surgery, and then participate in long-term monitoring of the child's growth and development and, if necessary, treat their difficulties, then pediatric thoracic surgery (surgically treating congenital malformations of the lungs, esophagus, pectus carinatum/excavatum), pediatric abdominal surgery, urology, traumatology, oncological surgery and pediatric transplant surgery.

In the last two decades minimally invasive surgery techniques (laparoscopy, thoracoscopy) have been developed in pediatric surgery which involve surgery through small incisions in the skin and the use of special instruments, which avoids possible complications of open surgery and contributes to a faster recovery of the child. At the same time, pediatric day surgery has begun to develop intensively and an increasing number of procedures are performed in day surgery. Minimally invasive surgery additionally allows for the performance of more complex procedures as part of day surgery.

Who are the candidates? 

At the St. Catherine Specialty Hospital are performed procedures that are applicable in children's one-day surgery: 

• Excision of skin, subcutaneous and soft tissue growths (birthmark, dermoid cyst, atheroma, lipoma, foreign body, ganglion...)
• Biopsy of skin, soft tissue, lymph node changes
• Wound treatment (wound suturing, dressing)
• Incision and drainage of skin and subcutaneous tissue abscess
• Ablation of ingrown toenail
• Incision and drainage of perianal abscess
• Excision of pilonidal sinus/cyst

• Inguinal hernia surgery (inguinal hernia)
• Laparoscopic surgery of inguinal hernia (inguinal hernia)
• Hydrocele surgery
• Umbilical hernia surgery (umbilical hernia)

• Circumcision
• Frenulotomy
• Orchidopexy of an undescended testicle
• Laparoscopic orchidopexy of an undescended testicle (cryptorchism)
• Varicocele surgery

At the St. Catherine Specialty Hospital are also performed specialist examinations, consultations and second opinion for: 

Soft tissue changes:

• Skin and subcutaneous growths (abscess, mole, dermoid cyst, atheroma, lipoma, foreign body, ganglion, hemangioma, etc.)
• Acute and chronic wounds
• Pilonidal sinus
• Ingrown nail

Hernias:

• Inguinal hernia, hydrocele
• Umbilical hernia
• Abdominal wall hernias

Urogenital diagnoses:

• Undescended testicle, cryptorchidism
• Phimosis
• Preputial adhesion
• Labial adhesion
• Short penile frenulum
• Varicocele
• Hydronephrosis
• Ureteral duplication
• Megaureter
• Vesicoureteral reflux (VUR)
• Posterior urethral valve
• Neurogenic bladder
• Hypospadias

Congenital anomalies of the digestive system:

• Esophageal atresia
• Congenital diaphragmatic hernia
• Abdominal wall defects – gastroschisis, omphalocele
• Anorectal malformations

Other:

• Gallstones
• Burns

What does the preparation for the examination look like? 

The child should be prepared for the examination depending on the child's age and ability to understand.

For early preschool children, the presence and support of the parent/guardian during the examination is most important because it gives them a sense of security and protection. If the child is upset, their toy or any other object that otherwise helps the child reduce anxiety can help them. The parent/guardian of a young child assists the doctor during the examination by holding the child on the examination table or on their lap.

Early preschool children should be told that they are going to see a doctor as soon as possible before the examination. They should also be told that the parent/guardian will be with them throughout the examination, where they will agree with the doctor how to help them solve the problem they have.

Preschool children should be told why they are going to the doctor (e.g. because of swelling in the groin area), that the parent/guardian will first talk to the doctor, that the doctor will then examine them and that the parent/guardian will be with the child the entire time.

Younger school-age children can be told more details about the examination. In addition to the reason for going to the doctor, the way in which the doctor will examine him can be described: in a standing position (e.g. inguinal hernia), lying down (e.g. inguinal hernia, umbilical hernia, undescended testicle, phimosis) or sitting position (e.g. changes in the soft tissues of the upper limbs, upper torso).

Older school-age children and adolescents should be involved in communication with the doctor during the examination.

Advice for parents/guardians: 

• Ask your child if there is anything else they are interested in about the examination.
• Ask your child if there is anything they are afraid of or worried about about the examination.
• Encourage your child to talk about their feelings.
• Emphasize to your child that the examination will not take long and that the doctor will do everything to ensure that the examination is not uncomfortable or painful. The child will have enough time to adjust and be cooperative, and if pain occurs, the examination will be interrupted.
• The parent/guardian provides the doctor with information about the child, but it is important that the child also actively participates in the conversation with the doctor, this is especially important when it comes to older school children and adolescents.
• If your child has any specific behavioral or developmental difficulties, let the doctor know about this so that he or she can adjust communication with the child during the examination.

Does your child need surgical treatment? Don't wait! Contact us with confidence at +385 1 2867 400 or email: info@stcatherine.com and arrange an examination today!