Definition and Overview
Pediatric surgery is a subspecialty of general surgery, a branch of medicine that deals with children from their infancy to their teenage years.
Although pediatric surgery also includes the diagnosis of the patient, it is more involved with the treatment, specifically surgical care. A pediatric surgeon, the term used for specialists in this field, develops the best treatment plan for the patient, conducts pre-operative examinations and preparations, and follows up on the patient's progress as part of the post-surgical care. He or she works closely with the patient's guardians and/or parents who will be responsible for the majority of the care. He or she may provide instructions and counseling, as well as refer them to support groups or other professionals who can perform therapies to better cope with the child's illness.
Pediatric surgery is divided into various types of expertise. Prenatal surgery is a brand-new concept in the field. It deals with a fetus or unborn child. Some defects can already be determined through ultrasounds and other examinations that can be performed on pregnant women. These tests are also often part of routine maternal and fetal care. A pediatric surgeon who specializes in this field usually works closely with sonographers and radiologists.
The other type of expertise in this field is called neonatal surgery, which focuses on babies (both full-term or premature) who require surgical procedures typically to correct a congenital abnormality that may prevent them from growing up normally or may be life threatening.
Meanwhile, pediatric oncology is a subspecialty of pediatrics that handles cancer-related cases. Just like in adults, surgery is often one of the first lines of treatment, particularly if there's a malignant tumor or mass present and it is still not invasive (it has not spread to other nearby organs).
Some pediatric surgeons specialize in trauma or injuries that result from accidents or violence. They often work with children who require emergency care and who are suffering from trauma.
When should you see a Pediatric Surgeon
A pediatric surgeon is needed when:
- The child is born with a congenital defect or experiencing trauma
- The surgery is expected to improve the mobility of the child (for example, a child can grow up with clubbed feet, but he or she still needs to be operated on to gain full function of the feet).
- The surgery is part of the overall treatment plan – This is more evident in pediatric oncology where surgery is often the first form of treatment applied to delay, arrest, or prevent the spread of the disease.
- The previous surgery did not work out, in which case the successive surgery is referred to as corrective
- The patient's health has to be monitored before and after the surgery
- The child has developed complications after the surgery such as infection, excessive bleeding, and organ failure
- Surgery is part of pain management
- Vascular access is needed (for example, a child may require chemotherapy delivered through a cath port)
Pediatric surgeons can now perform both invasive and minimally invasive surgeries. In invasive surgeries, a bigger cut is needed, in which case, the surgical risks are higher and recovery longer. In minimally invasive surgeries, smaller incisions and scopes are used to improve precision and accuracy. Recovery and risks are expected to be minimal. However, there are cases when open surgery is recommended, especially for advanced or more serious conditions.
Pediatric surgeons require comprehensive education and training. Aside from four years of bachelor's and medical degrees, they also have to spend at least four more years in residency for surgery. They are also required to train for two more years for pediatric surgery. In addition, they are required to pass different certifications or board exams. A membership in a fellowship program can also boost their credentials.
Recommendations for preparing children and adolescents for invasive cardiac procedures: A statement from the American Heart Association Pediatric Nursing Subcommittee of the Council on Cardiovascular Nursing in collaboration with the Council on Cardiovascular Diseases of the Young. Circulation. 2003;108:2250-2564.
Webb GD, Smallhorn JF, Therrien J, Redington AN. Congenital heart disease. In: Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 8th ed. St. Louis, Mo; WB Saunders; 2007:chap 61.