Surgery

When is surgery an option?

You and your child's physician will discuss surgery as a way to correct your child's health problem after it is diagnosed. This decision is based on careful evaluation of your child's medical history and subsequent medical tests, such as blood tests, x-rays, MRI, CT scan, electrocardiogram (EKG), or other laboratory work performed to determine the exact diagnosis.

What are the different types of surgery?

Surgery can be classified as major or minor, depending on the seriousness of the illness, the parts of the body affected, the complexity of the operation, and the expected recovery time.

• Major surgery - These operations most often occur on the head, neck, chest, and abdomen, and can greatly affect the way the body functions. The recovery time can be lengthy and may involve a stay in intensive care or at least several days in the hospital. There is a higher risk of complications after such operations. In children, types of major surgery may include the following:
  • removal of brain tumors or other solid tumors
  • correction of bone malformations of the skull and face
  • repair of congenital heart disease, transplantation of organs, and repair of intestinal malformations
  • correction of spinal abnormalities and treatment of injuries sustained from major blunt trauma
• Minor surgery- Some procedures that children undergo are considered minor. The recovery time is short and children return to their usual activities rapidly. These operations are most often done as an outpatient, and children can return home the same day or after an overnight hospital stay. Complications from these types of operations are rare. Examples of the most common types of minor surgery may include the following:
  • placement of ear tubes
  • hernia repairs
  • correction of bone fractures
  • removal of skin lesions
  • biopsy of growths
• Elective surgery - These are procedures you decide your child should undergo, to assure a good quality of life for your child. An example might be to have a birthmark removed, or to circumcise your baby boy.
• Urgent or emergency surgery - This type of surgery is done in reaction to an urgent medical condition, such as correction of a life-threatening congenital heart malformation or repair of injured internal organs after an automobile accident, or a problem such as appendicitis.
• Required surgery - These are procedures that need to be done to make your child's life better in the future. An example might be having a spinal fusion to correct severe curvature of the spine. Required surgery, unlike emergency surgery, does not necessarily have to be done immediately and can allow you time to prepare your child for the experience.

How will my child's surgery be performed?

With technical advances today, surgery does not necessarily mean large incisions, as in the past. Depending on the type of surgery, there are several surgical methods that may be performed, including the following:

• Open surgery- An open operation means cutting skin and tissues so the surgeon has a full view of the structures or organs involved. Examples of open surgery include the removal of organs, such as the kidney.
• Minimally invasive surgery - Minimally invasive surgery refers to any surgical technique that does not require a large incision. This relatively new approach allows your child to recuperate faster and with less pain. Not all conditions are suitable for minimally invasive surgery. Some surgical techniques that are considered minimally invasive surgery include the following:
  • Laparoscopy- A test that uses a tube with a light and a camera lens at the end (laparoscope) to examine organs and check for abnormalities. Laparoscopy is often used during surgery to look inside the body and avoid making large incisions. Tissue samples may also be taken for examination and testing. Procedures commonly done include gallbladder removal, appendix removal, and selected solid organ removal.
  • Endoscopy- A test that uses a small, flexible tube with a light and a camera lens at the end (endoscope) to examine the inside of part of the digestive, respiratory or urinary tract. Tissue samples from inside the digestive tract may also be taken for examination and testing.
  • Arthroscopy- With the use of an endoscope, surgeons can look at the interior of a joint. This technique is most often used to inspect the inside of the knee joint.
  • Bronchoscopy- Examining the bronchi (the main airways of the lungs) using a flexible tube. Bronchoscopy helps to evaluate and diagnose lung problems, assess blockages, obtain samples of tissue and/or fluid, and/or to help remove a foreign body.
  • Cystoscopy- Examining the inside of the urethra and bladder cavity with a small, flexible tube with a light and a camera lens at the end.
  • Gastroscopy- Examining the lining of the esophagus, stomach, and the first part of the small intestine with a small, flexible tube with a light and a camera lens at the end.
  • Laryngoscopy- Inspecting the larynx (voice box) with a small, flexible tube with a light and a camera lens at the end (endoscope).
  • Sigmoidoscopy- Examining the rectum and sigmoid colon with a small, flexible tube with a light and a camera lens at the end (endoscope).