Neonatal Surgery

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Neonatal Surgery

Neonatal Surgery is a specialised branch of Pediatric surgery where the pediatric surgeon is called to operate on new born babies that weigh from 1.5 kg to 3 kg.
The main aspects are smaller structures, delicate handling of tissues and majority of congenital anomalies has to be operated within twenty four hours of birth. Neonatal surgery evolved alongside pediatric surgery. Initially the morbidity and mortality are very high, but with the invention of warmers, better neonatal anesthesia techniques, Neonatal ventilators the sucess and survival rates are high. We have twenty bedded surgical new born ward at ICH, and seperate operation theatre for new born.

We operate more than thousand new born surgeries every year, we have well trained staff nurses to handle post op new born babies, each pediatric surgeon operate averagely ten cases of new born per month.

The common surgical problems new born are Anorectal malformation (ARM), Esophageal Atresia and Trachea Esophageal Fistula (EA & TEF), Hirschsprung's disease, Bowel Atresia, Intestinal Malrotation, Congenital Lobar Emphysema (CLE), Congenital Cyst Adenomatoid Malformation (CCAM), Congenital Diaphragmatic Hernia (CDH). Exomphal major and minor,(Umblical Ring is wide opened, allows abdominal contents liver, small intestine to come out with covering), Gastrochisis (small bowel comes out of abdominal wall lateral to umbilical ring).

I have done more than a thousand new born surgeries individually and supervised, assisted MCh trainees nearly two thousand cases.

Common Pediatric Neonatal Surgical Conditions are:

Oesophageal Atresia & Tracheo-Oesophageal Fistula

Oesophagus (Food pipe ) stops growing, also the lower part connect with trachea (win pipe) has to be operated within 24 hrs of birth.

Congenital Diaphragmatic Hernia

Huge defect in diaphragm, so the abdominal contents (Intestine, spleen) gets into thorax, the baby will have sever respiratory distress , the baby has to be managed both medically and surgically.

Bowel Atresia

Intestine stops growing in between, the baby has to be operated with in 24hrs.

Ano – Rectal Malformation (ARM)

In this condition the baby will not have anal orifice (last 2 to 4 cm of large intestine fails to develop) has to be operated immediately (within 24hrs)

My Advice on Common Conditions

Appendicitis

Most common acute surgical condition in pediatric age group incident is nearly nine percent in male children and seven percent in female children.

Congenital pyloric stenosis

This occurs between 4th week of age to 6 week of age, can occur in new born also, exact cause not known.

Habit Constipation

This is one of the common condition - a child with constipation may have bowel movements less frequently than normal, hard bowel movements, or large, difficult, painful bowel movements.

Hernia - Hydrocele

A small passage has developed or left open connecting the belly to baby's groin, the second common surgical condition next to phimosis.

Hypospadias

Abnormal opening of Urethral opening in the under surface of penis, very common pediatric urological problem Incidence is one in five hundred.

Intussusception

Intussusception is the invagination of one part of intestine into another. This occurs in one in 2000 infants. It is the most common abdominal emergency in infants.

Phimosis

Narrowing of foreskin or non retractile foreskin. Empty scrotum one side or both sides, can be identify in new born. It can descend in three to four months without any intervention.

Tongue Tie

Is a congenital oral anomaly which may decrease mobility of tongue tip & is caused by an unusually short thick lingual frenulum.

Undescended Testis

Undescended testis is found in 3% of term boys and 30% of preterm boys.
When the baby is formed in the womb, the testis is initially formed inside the baby’s belly.

Wilms Tumour

This is one of the most common childhood tumour, it affect the kidney, usually affects school going kids, one of the good prognostic tumour.

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Dr. C. SankkaraBarathi

MBBS, MS (Gen), MCh (Paediatric Surgery)


Paediatric Surgeon

Paediatric Urologist

All Department

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