Paediatric Surgery

What is a Paediatric Surgeon?

When your child needs medical treatment, you would want him or her to have the best care available. So, it stands to reason that if your child requires an operation, you would want to consult a surgeon who is qualified and experienced in operating on children.

Such a surgeon is known as a Paediatric Surgeon, who operates on children ranging from the newborn stage through to the teenage years.

Paediatric surgeons are highly specialized surgeons, who are also trained in Paediatric Urology. Almost 40% of the paediatric surgeon’s work is concerned with urological problems of childhood.

What is the paediatric surgeon’s role in treating the child?

Paediatric surgeons are primarily concerned with the diagnosis, preoperative (before surgery), operative and postoperative (after surgery) management of surgical and urological problems in children. Some medical conditions in newborns can only be corrected surgically.

These conditions must be recognized immediately by neonatologists, paediatricians and family physicians. Paediatric surgeons cooperate with all specialists involved in a child’s medical care to determine whether surgery is the best option for the child.

What is the focus of paediatric surgery?

Paediatric surgeons utilize their expertise in providing surgical care for all problems or conditions affecting children that require surgical intervention. They participate in transplantation operations and, like most surgeons today, they use laparoscopic techniques for many operations.

They also have particular expertise in the following areas:

Neonatal – Paediatric surgeons have specialized knowledge in the surgical repair of congenital birth defects, some of which may be life-threatening to premature and full-term infants.

Prenatal – Paediatric surgeons, in cooperation with radiologists, use ultrasound and other technologies during the foetal stage of a child’s development to detect any abnormalities. They can then plan corrective surgery, educate and get to know parents before their baby is born. Prenatal diagnosis may lead to foetal surgery, which is a new forefront in the subspecialty of paediatric surgery. Application of most foetal surgical techniques is still in the experimental stage.

Trauma – Childhood trauma is becoming more common and paediatric surgeons are routinely faced with critical care situations involving traumatic injuries sustained by children that may or may not require surgical intervention. Many paediatric surgeons are involved in accident prevention programmes in their communities that are aimed at curbing traumatic injuries in children.

Paediatric Oncology – Paediatric surgeons are involved in the diagnosis and surgical care of children with malignant tumours as well as those with benign growths.

How are paediatric surgeons trained and certified?

Paediatric Surgical training is currently a 4-6 year training programme. Paediatric surgical training also includes extensive training in paediatric urology and is structured in such a way that the surgeon acquires good experience in all aspects of paediatric surgery and paediatric urology.

At the end of the training period, one has to successfully pass a formal written and oral examination in front of a board of examiners in order to be awarded the sub speciality degree.

List Of Common Paediatric Surgical Problems & Procedures

  • Circumcisions
    • Modern technique with very good cosmetic results
  • Hernias
    • Inguinal
    • Umbilical
  • Hydrocoeles and Varicocoele (laparoscopic management)
  • Testicular Problems
    • Problems with testicular descent- undescended testis or absent testis (laparoscopically managed)
    • Testicular torsion
    • Investigation of scrotal and testicular pain
  • Constipation
    • Complete investigation and management of constipation
  • Abdominal Pain
    • Thorough investigation and complete management including diagnostic laparoscopy
  • Appendicitis
    • Investigation, diagnosis and laparoscopic appendicectomy with excellent cosmetic results
  • Bleeding From The Gastro Intestinal Tract
    • Thorough investigation and fibre-optic endoscopy and diagnosis
  • Various Lumps And Swellings That Require Surgery
  • Urinary Incontinence And Bed Wetting
    • Detailed examination , investigation and management
  • Hypospadias Reconstruction
    • Complete reconstruction of this severe defect with good cosmetic and functional outcome
  • Treatment of All Forms of Congenital Problems of the Gut
    • Hirschsprung’s disease of the colon
    • Ano- rectal malformations
    • Atresia of the intestines
    • Management of necrotizing enterocolitis
  • Treatment of Various Renal Tract Abnormalities
    • Kidney obstruction
    • Vesico-ureteric reflux management and surgery
    • Ureteric abnormalities
    • Urachal abnormalities
    • Bladder abnormalities
  • Laparoscopic Surgery in Childhood
    • Many conditions are treated laparoscopically with good outcomes, minimal pain and excellent cosmetic results without the need for large incisions.
  • Tumour Surgery
    • Tumour biopsies, also done laparoscopically if needed
    • Insertion of chemoport and central lines for chemotherapy
    • Neuroblastoma Surgery
    • Wilms’ tumour Surgery
    • Liver tumour resections
    • Lymphoma and non-Hodgkin’s lymphoma surgery

Paediatric Surgery Specialist(s)

Mr. Nadesh Sithasanan

Mr. Nadesh Sithasanan

Resident Consultant