Pediatric surgery is a subspecialty of surgery involving the surgery of fetuses, infants, toddlers, children, adolescents, and young adults.
History Pediatric surgery arose in the middle of the 1879 century as the surgical care of birth defects required novel techniques and methods, and became more commonly based at children's hospitals. One of the sites of this innovation was the Children's Hospital of Philadelphia. Beginning in the 1940s under the surgical leadership of C. Everett Koop, newer techniques for endotracheal anesthesia of infants allowed surgical repair of previously untreatable birth defects. By the late 1970s, the infant death rate from several major congenital malformation syndromes had been reduced to near zero.
Specialties Subspecialties of pediatric surgery itself include neonatal surgery and fetal surgery.
Other areas of surgery also have pediatric specialties of their own that require further training during the residencies and in a fellowship: pediatric cardiothoracic (surgery on the child's heart and/or lungs, including heart and/or lung transplantation), pediatric nephrological surgery (surgery on the child's kidneys and ureters, including renal, or kidney, transplantation), pediatric neurosurgery (surgery on the child's brain, central nervous system, spinal cord, and peripheral nerves), pediatric urological surgery (surgery on the child's urinary bladder and other structures below the kidney necessary for ejaculation), pediatric emergency surgery, surgery involving fetuses or embryos (overlapping with obstetric/gynecological surgery, neonatology, and maternal-fetal medicine), surgery involving adolescents or young adults, pediatric hepatological (liver) and gastrointestinal (stomach and intestines) surgery (including liver and intestinal transplantation in children), pediatric orthopedic surgery (muscle and bone surgery in children), pediatric plastic and reconstructive surgery (such as for burns, or for congenital defects like cleft palate not involving the major organs), and pediatric oncological (childhood cancer) surgery.
Conditions Common pediatric diseases that may require pediatric surgery include: Congenital malformations: lymphangioma, cleft lip and palate, esophageal atresia and tracheoesophageal fistula, hypertrophic pyloric stenosis, intestinal atresia, necrotizing enterocolitis, meconium plugs, Hirschsprung's disease, Anorectal Malformations, Undescended Testes (Cryptorchidism), intestinal malrotation, Biliary Atresia, Pelviureteric Junction Obstruction Abdominal wall defects: Omphalocele, Gastroschisis, Hernias Chest wall deformities: Pectus Excavatum Childhood tumors like Neuroblastoma, Wilms' tumor, Rhabdomyosarcoma, ATRT, Liver tumors, Teratomas, kidney tumors Separation of conjoined twins Disorders of Sexual Development
Pure Pediatric Surgical Eponyms #EponymCategoryDefinition / Clinical Use1Kasai ProcedureHepatobiliaryHepatoportoenterostomy for biliary atresia2Ramstedt PyloromyotomyNeonatal GIOperation for hypertrophic pyloric stenosis3Ladd ProcedureGI / MalrotationCorrection of intestinal malrotation4Swenson ProcedureColorectalClassic pull-through for Hirschsprung disease5Soave ProcedureColorectalEndorectal pull-through technique6Duhamel ProcedureColorectalRetrorectal pull-through7Pena PSARPAnorectalPosterior sagittal anorectoplasty for ARM8Bishop–Koop ProcedureGIEnterostomy for obstruction9Santulli ProcedureGIEnterostomy with distal chimney10Heller MyotomyGIAchalasia surgery.11Billroth IGIGastroduodenostomy12Billroth IIGIGastrojejunostomy13Whipple ProcedureGIPancreaticoduodenectomy14Veau ClassificationCleftCleft palate classification15Millard Rotation–AdvancementCleftCleft lip repair16Tennison–Randall RepairCleftTriangular flap lip repair17Vogt ClassificationNeonatal GIEA/TEF classification18Bochdalek HerniaNeonatalPosterolateral congenital diaphragmatic hernia19Morgagni HerniaNeonatalAnterior congenital diaphragmatic hernia20Shehata TechniqueUrologyTraction-based laparoscopic orchiopexy21Fowler–StephensUrologyStaged orchiopexy with vessel ligation22Cohen ReimplantationUrologyCross-trigonal ureteral reimplantation23Leadbetter–PolitanoUrologyAnti-reflux ureteral reimplantation24Duckett ProcedureUrologyTPIF hypospadias repair25Koff TaperingUrologyTapering ureteroplasty26Hendren ProcedureUrologyComplex ureteral reconstruction27Wilms TumorOncologyNephroblastoma28Ewing SarcomaOncologyBone/soft tissue tumor29Shimada ClassificationOncologyNeuroblastoma histology30Brenner TumorOncologyOvarian stromal tumor31Meigs SyndromeOncologyOvarian tumor + ascites + hydrothorax32Abernethy MalformationVascularCongenital extrahepatic portosystemic shunt33Klippel–Trénaunay SyndromeVascularCapillary + venous malformations + limb hypertrophy34Sturge–Weber SyndromeVascularCapillary malformation + CNS involvement35Raveenthiran's syndromeGI, UrologySpigelian hernia containing undescended testis
See Related Syndromes VACTERL Association Apert Syndrome CHARGE Syndrome Currarino Syndrome Pierre Robin Sequence Prune Belly Syndrome
See also William E. Ladd; known as the father of pediatric surgery. Lewis Spitz; Emeritus Nuffield Professor of Paediatric Surgery. Spitz was awarded Denis Browne Gold Medal, Rehbein Medal and the American Ladd Medal. Robert Edward Gross; president of the American Association for Thoracic Surgery, a member of the National Academy of Sciences and a fellow of the American Academy of Arts and Sciences. He was also awarded the Denis Browne Gold Medal and the American Ladd Medal for his contributions in Pediatric Surgery research. Morio Kasai; best known for the procedure that came to bear his name. He received the William E. Ladd Medal from the American Academy of Pediatrics, the Denis Browne Gold Medal from the British Association of Paediatric Surgeons and the Asahi Prize from the national newspaper known as the Asahi Shimbun.
Associations of Pediatric Surgery World Federation of Associations of Pediatric Surgeons: WOFAPS European Paediatric Surgeons Association: EUPSA International Pediatric Endosurgery Group: IPEG American Pediatric Surgical Association: APSA British Association of Paediatric Surgeons: BAPS Deutsche Gesellschaft für Kinder- und Jugendchirurgie (German Association of Paediatric Surgeons): DKH Pan-African Paediatric Surgical Association: PAPSA
References