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Contrary to the common concerns of safety of surgery and anaesthesia in children, surgery in kids has evolved into a specialised branch of Medicine with excellent results. Well qualified and experienced Pediatric Surgeons, Pediatric Anaesthesiologists and paramedical staff ensure that the surgery is as convenient and smooth as possible for the delicate souls.
Babies including newborns have always been stressful for parents given the pain and the long scars in their loved ones. Added to this would be a lot of other factors like staying with the child in the hospital for long days, face the trauma of seeing them with all the drips and tubes and the recovery period at home till they are back to normal. A scar on the child’s body is a scar on the parents’ heart. The long scar which would be a lifelong reminder of the unfortunate event, usually a social stigma is any parent’s nightmare.
Contrary to the above scenario, surgery in kids is not what it used to be a few years ago. Surgical care for children has had lots of technical innovations and changes in post-operative care that it is more child and parent friendly. Major cases can be done with extreme safety, with minimal scars, with short hospital stay and quicker recovery. The factors that have made this possible are discussed below.
Surgical Innovations-Minimal Access Surgery (MIS)MIS (Laparoscopy) is a surgical approach to a problem which traditionally involves a cut/incision to correct the problem, which by the MIS method can be done with small holes. MIS in children is done regularly worldwide in major pediatric surgical centres and also in a few centres in our country. The safety and success of MIS has been proven by many evidence based studies in multicentre trials and has become the prescribed standard of care for many conditions. However the success and safety always depends on the experience of the pediatric surgeon and the expertise of the pediatric anaesthetist. The advantages are:
• Magnified view during surgery and hence more accurate dissection and repair possible
• Minimal postoperative pain
• Early recovery
• Early discharge
• The most minimal scar
• Less of post-operative adhesions and long term complications
Safe, specialized and effective Anaesthesia practices
Anaesthesia for babies is a specialized branch where emphasis is on safe practices of anaesthesia, appropriate monitoring, and optimal post-operative pain relief. The entire process of surgery is smooth, painless and less traumatic for the child and parent. The child is usually anaesthetized in the presence of parents thereby preventing the parental separation anxiety and by the time they recover after surgery and come to their senses, they are back with the parents. Many newer technical innovations of regional anaesthesia have significantly reduced pain after surgery for long hours.
The high rate of successful surgery seen in children today is also due to the excellent post-operative care in specialized ICUs where the Pediatric Intensivists are involved in monitoring, evaluating and managing all the child’s vital parameters.
Admission, Recovery and discharge
Most minor procedures are done as day care surgeries where children are sent home within hours of the procedure. Fasting before anaesthesia is mandatory and for babies, breast feeds are allowed until four hours and clear fluids until two hours prior to surgery. Feeding can be started immediately after the child is out of anaesthesia except for intestinal surgeries. Parents are encouraged to handle the baby normally after surgery and be close to them.
Surgery doesn't have to be a negative experience for children and their parents. In today’s Pediatric Institutions, personnel are trained to be child and family-friendly in order to meet both the emotional and medical needs of children and their families. An environment that diminishes a child's and parent's anxiety can in turn facilitate a faster recovery.
DAY CARE SURGERIES
o Herniotomy (Open & Lap)
o Orchiopexy (Open & Lap)
o Sinuses & Fistulae of neck
o Easy Admission & Discharge process
o Package for General Ward Patients (All Inclusive)
o Child friendly pre-op area
o Measures to reduce separation anxiety of Parents and Children
o Safe regional anaesthesia with minimal sedation for most day care procedures.
o Appropriate monitoring post-op.
MBBS, MS, MCH
Rainbow Children's Hospital, Banjara Hills, Hyderabad