Know Things Related to Child Surgery

 

Pediatric surgery is a collection of surgical procedures performed to treat various types of diseases in children, ranging from internal organ disorders to tumors . Many differences are found in surgical procedures in children and adults. Therefore, doctors who deal with pediatric surgical procedures are different from general surgeons.

Pediatric surgery developed in the mid-20th century, more precisely around the 1950s, where there were still many threats of death to babies caused certain diseases, but treatment and treatment are not yet available. Pediatric surgery focuses only on the implementation of procedures for handling diseases in children. Doctors who specifically deal with pediatric surgery are called pediatric surgeons (Sp. BA).

Know Things Related to Child Surgery

Indications for Pediatric Surgery

Pediatric surgery is generally done to treat the condition:

  • Congenital heart disease. Abnormalities in heart structure from birth so that it disrupts heart function, and causes symptoms of fatigue, irregular heartbeat, and chest pain.
  • Patent d uctus a rteriosus (PDA). PDA is a condition where ductus arteriosus is still open even though even the baby is born. Ductus arteriosus is a blood vessel that the baby needs as a respiratory system during the womb. These blood vessels normally close when the baby is born. However, if the ductus arteriosus is still open when the baby is born, it will cause complaints of shortness of breath, rapid heart beat, and fatigue.
  • Intestinal atresia. Intestinal atresia is a congenital defect in which there are several parts of the intestine that are narrowed or severed. This condition causes interference with the baby's digestive system.
  • Esophageal atresia. Abnormalities from birth where the esophagus does not develop as it should. This causes the baby to have difficulty swallowing and shortness of breath.
  • Tracheoesophageal fistula. Abnormalities of growth in the esophagus and trachea . The esophagus and trachea are two separate channels. The esophagus is a tube (channel) to distribute food that is consumed from the mouth to the stomach, while the trachea is the channel of entry of air into the lungs. When the child has this condition, the esophagus is cut off and connects to the trachea. Connecting the esophagus to the trachea can certainly impair lung and stomach function.
  • Diaphragmatic hernias. Abnormalities from birth where there is a gap in the diaphragm that makes the organs in the abdominal cavity, such as the intestine, stick through the diaphragm and enter the chest cavity. This condition causes tightness and the heart beats fast.
  • Omphalocele. An abnormality in which the intestine or other body organs come out through a hole or gap in the navel. This condition can cause organs that come out of the navel to not get enough blood supply, so that its function is disrupted.
  • Wilms tumor. Wilms tumor is a tumor that attacks the kidneys. This condition causes symptoms of fever, constipation, and pain in the abdomen.
  • Neuroblastoma. Cancer that develops from immature nerve cells. Symptoms include fever, weight loss, and loss of appetite.
  • Pyloric stenosis. Pyloric stenosis is an abnormality in which the pyloric muscle increases in size and thickness. The pyloric muscle is a muscle that functions to hold the incoming food, until the stomach is ready for the next digestive process. Abnormalities in the pyloric muscles can cause obstacles to the digestive process of the stomach in the stomach. This interferes with the distribution of food and fluids, the blood supply, and can even cause swelling and pain.
  • Midgut volvulus. An abnormality in which the intestine is twisted or bound because of a spinning error when the fetus develops in the womb. This condition can cause symptoms in the form of vomiting and pain in the abdomen.

Warning

Each surgical procedure in children has different provisions - different. Consult a doctor before the procedure is done.

Surgical procedures generally use anesthesia. In addition, some procedures also use antibiotics to avoid infection. If you have a history of allergies to anesthesia or antibiotics, consult a doctor so that the treatment can be adjusted.

When using anesthesia, your doctor will encourage patients to avoid using drugs containing aspirin. Also, tell your doctor if you are using supplements or herbal products, such as:

  • Ginseng
  • Garlic
  • Ginkgo biloba

Likewise with blood thinning drugs that can increase the risk of bleeding. Usually the doctor will ask the patient to stop using the drug, at least 1 week before surgery. Tell your doctor if you are using blood thinning medications, such as:

  • Apixaban
  • Aspirin
  • Warfarin
  • Heparin
  • Rivaroxaban
  • Dabigatran

Child Surgical Preparation

Initially, the doctor will start by conducting a question and answer session. The patient's parents or the patient himself will be asked to describe the complaint, the history of the illness he has, and the medicines he is taking. Some procedures also have provisions or require special measures, such as urine tests for Wilms tumor surgery.

Each child surgical technique has different preparations. But generally, the doctor will do the examination first. Examination is done to find out other diseases that may be suffered or any allergies that exist.

Examinations performed by doctors can be in the form of imaging methods such as MRI and CT scan, or even in the form of blood tests. The results of the examination will be used to support the smooth procedure that will be carried out. Because most pediatric surgery uses general anesthesia , the doctor will ask the patient to fast for 6 hours before anesthesia is given and the procedure begins.

Child Surgical Procedure

In the initial stages, the patient will be taken to the operating room. The doctor will wear special clothes that have been provided to the patient. Furthermore, the patient will be positioned at the place of surgery, either in a sitting, supine, or prone position, depending on the surgical procedure to be performed.

Then the doctor will give anesthesia, can be local, regional or general anesthesia (anesthesia total), so that the patient does not feel pain due to incision during the procedure. When the patient begins to lose consciousness, the doctor will attach a breathing tube through the patient's mouth . Before the surgical process is performed, the area of ​​the skin to be surgically removed is cleaned first with a special antiseptic liquid. This is done so that the patient can avoid infection.

After the area of ​​the skin to be surgically removed has been cleaned, the procedure is followed by an incision. The number and size of incisions and their locations vary depending on the conditions being overcome. For example in the procedure for handling a hernia, the incision is only 1-2 cm.

There are also several procedures that use assistive devices in their implementation. As for surgery performed to treat a hernia, a laparoscope is used to assist doctors in seeing the condition of the organ while at the same time facilitating the operation.

After Pediatric Surgery

Generally, after child surgical procedures are performed, doctors will recommend that patients stay in the hospital for several days until the condition recovers and allows to go home. This is intended to make it easier for doctors to carry out postoperative surveillance.

In some procedures, the breathing tube remains attached to the patient. The hose will be released when the patient has recovered and can move normally.

Side effects of the procedure can occur in each patient. Different procedures, different side effects can occur. In some cases, surgical incisions will cause pain, redness, or swelling. This is quite normal and can last for several days after surgery. If the pain in the incision is very disturbing, the doctor may prescribe painkillers.

The patient's parents can also do independent treatment of the incision, so that the wound is not infected and heals faster. Some treatments that can be carried out include:

  • Avoid incisions exposed to water, at least 24 hours after surgery. However, it would be better if it was consulted by a doctor.
  • Clean the skin around the incision with a sterile soft cloth.
  • Avoid cleaning the skin around the incision with antibacterial soap, alcohol, iodine, or peroxide. Using these ingredients can slow down the recovery period for incisions.
  • Avoid activities or movements that can pull or press the skin around the incisions.

Patients are allowed to go home when their condition pretty good. The duration of the procedure and recovery varies depending on the actions taken and the conditions being treated.

Child Surgical Risk

The risks for each procedure vary. However, because pediatric surgical procedures generally require an incision, some risks can occur, namely:

  • The incision area is painful
  • Scars and surrounding skin experience swelling
  • The skin color in the area around the incision is red

In addition, many child surgical procedures also use anesthesia. The use of anesthesia can cause complaints in the form of:

  • Nausea
  • Dry mouth
  • Sore throat
  • Sleepy
  • Hoarseness
  • Vomiting

In some procedures, antibiotics are given to the patient to minimize infection. However, antibiotics themselves can cause side effects, such as:

  • Diarrhea
  • Vomiting
  • Stomach pain

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