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Pediatric Cardiac Surgery

What is pediatric surgery?

This is a subspecialty of surgery that involves diseases and conditions in fetuses, infants, children and adolescents that require surgical intervention. Pediatric surgeons diagnose, treat and manage the surgical needs of children. From minor endoscopic procedures to major and complex procedures such as repairing birth defects and separating conjoined twins.

Who is a pediatric surgeon?

This is a medical doctor who has specialized in diseases and disorders affecting fetuses, infants, children, and adolescents. They have special expertise and are uniquely equipped to treat children.

Pediatric surgeons know how to ask children medical questions in a way that does not intimidate them. They are patient, friendly and interactive. In addition, they decorate their offices and operating rooms with reading materials, videos and wall cartoons. The equipment used is specially designed for use by children.

Training

Pediatric surgeons are medical doctors who have had at least 4 years of medical school, 5 years of general surgery and at least 2 years of residency in pediatric surgery.

Subspecialties of pediatric surgery

Pediatric surgery can further be subdivided into subspecialties namely neonatal surgery and fetal surgery.

Other surgical specialties also have pediatric subspecialties which require the doctors to undertake additional training.

• Pediatric cardiothoracic: surgery on the child’s heart and lungs, which include heart and/or lung transplantation

• Pediatric neurosurgery: surgery on the child’s brain, spinal cord, central nervous system and peripheral nerves.

• Pediatric orthopedic surgery: surgery on the child’s muscles and bones

• Pediatric nephrological surgery: surgery on the child’s kidneys and ureters. This includes kidney transplantation.

• Pediatric urological surgery: surgery on the child’s urinary bladder and other structures below the kidney.

• Pediatric plastic and reconstructive surgery: surgery on the child due to burns or congenital defects like cleft palate that does not involve the major organs

• Pediatric oncological surgery: surgery on the child to treat or manage cancer

• Pediatric hepatological and gastrointestinal surgery: surgery on the liver, stomach, and intestines which include liver and intestinal transplantation

Conditions treated through pediatric surgery include:

• Hirschsprung's disease

• Meconium ileus

• Imperforate anus

• Achalasia

• Ambiguous genitalia

• Appendicitis

• Congenital malformations

• Cleft lip and palate

• Bilary dyskinesia

• Esophageal atresia and transoesophageal fistula

• Annular pancreas

• Bilary atresia

• Pancreatic cysts

• Pancreatitis

• Torsion of testicular appendix

• Breasts problems

• Congenital diaphragmatic hernia

• Mediastinal cysts

• Chest wall deformities

• Lymphangioma

• Choledochal cysts

• Conjoined twins

• Torticollis

• Cystic hygroma

• Empyema

• Short bowel syndrome

• Umbilical hernia

• Meckel’s diverticulum

• Pyloric stenosis

• Epididymitis and orchitis

• Thyroiditis

• Gastroesophageal reflux

• Cholecystitis acalculous

• Pancreas divisum

• Cholelithiasis (gallstones)

• Parathyroid

• Gastrointestinal foreign bodies and bezoars

• Thyroid nodules

• Hepatoblastoma

• Hyperinsulinism

• Hyperthyroidism

• Inguinal hernia

• Umbilical polyps

• Intussusceptions

• Laparoscopic cholecystectomy

• Undescended testis

• Lung lesions

• Branchial cysts, sinuses, and remnants

• Malrotation and volvulus

• Anorectal malformations

• Small left colon syndrome

• Neck abnormalities

• Perirectal abscess

• Omphalocele

• Pancreas tumors

• Pectus carinatum

• Nectrotizing enterocolitis

• Pectus excavatum

• Pediatric cancer

• Spleen problems

• Neuroblastoma

• Testicular torsion

• Thyroid cancer

• Ulcerative colitis

• Wilm’s tumor

Pediatric Neurology

What is pediatric neurology?

This is a subspecialty of medicine that focuses on the diagnosis, treatment, and management of diseases and disorders of the nervous system in infants, children and adolescents. This includes the brain, spine, and spinal cord.

Who is a pediatric neurologist?

This is a medical doctor who has special training in treating disorders involving the nervous system in infants, children, and adolescents.

Training

Pediatric neurologists have completed 4 years of medical school, at least 1 year of residency in pediatrics and at least 3 years of residency in adult and pediatric neurology.

Why see a pediatric neurologist?

Pediatric neurologists have the special training that allows them to deal with pediatric patients and provide them with the best care possible. They have great knowledge and understanding of pediatric nervous system disorders.

They collaborate with other doctors and professionals to ensure that the overall care is comprehensive. These include dieticians, primary care physician, speech therapists and other pediatric specialists.

Conditions treated

Seizure disorders such as febrile convulsions, seizures in newborns and epilepsyWeakness including cerebral palsy, muscular dystrophy, and nerve-muscle disordersBehavioral disorders such as attention-deficit or hyperactivity disorder (ADHD), autism and sleep problemsDevelopmental disorders such as developmental delay, delayed speech, motor milestones, and coordination issuesMedical aspects of brain tumors and head injuriesBrain injuries including concussionsHeadaches, including migrainesHydrocephalusCerebral palsyNeurogenetic disordersStrokeNeurofibromatosis

Tests and procedures performed include:

Electroencephalogram (EEG): This is a noninvasive and pain-free test which measures brain signals using special sensors attached to the head. This test determines the cause of seizures as well as pinpoints various neurological conditions.Electromyography (EMG): This test assesses the health f the nerves controlling the muscles and the muscles. A needle is inserted into the muscle and electrical activity when nerves are stimulated is observed. The electrical activity is displayed on an oscilloscope. This test assists the doctor to differentiate primary muscle conditions from muscle weakness due to neurological disorders.Nerve conduction velocity test: This test is usually performed in conjunction with an EMG to evaluate the speed of conduction of impulses through a nerve. Electrodes are placed on the skin to stimulate the nerves with mild electrical impulses. This test is used to diagnose and evaluate nerve destruction and damage.Evoked potential tests: These tests gauge the transmission of electrical signals within the spinal cord and brain. It is used to diagnose conditions such as multiple sclerosis. Lumbar puncture: This test measures the intercranial pressure. The test can also be sued to remove cerebrospinal fluid for further laboratory testing. A small needle is inserted between the lumbar vertebrae and pressure measurements are taken or cerebrospinal fluid is removed. The test is used to determine if a headache and vision problems are due to increased pressure.Sleep tests: Sleep studies record your child’s physical state at various stages of wakefulness and sleep. A sleep test is also referred t as a polysomnogram. It provides information that is useful in diagnosing sleep problems.Radiology tests: These are tests that produce images of the inside of the body. They are also called imaging tests. They use various energy forms which are passed through the body to produce the images.

Pediatric Neurosurgery

What is pediatric neurosurgery?

This is a subspecialty of that specializes in the diagnosis, treatment, and management of children with various neurosurgical disorders. These problems involve the head, spine, and nervous system.

Why see a Pediatric Neurosurgeon?

Pediatric neurosurgeons treat neurosurgical problems that are quite different from those generally seen by general neurosurgeons. Pediatric neurosurgeons have specialized in treating pediatric neurosurgical diseases. Children with neurosurgical diseases often require frequent and regular follow-ups throughout their childhood. They forge a longstanding relationship with the child so that the child is comfortable and relaxed.

Children sometimes cannot say what is bothering them. Answering medical questions can be difficult and they may not be cooperative or patient while undergoing a medical examination. Pediatric neurosurgeons have the extra knowledge on how to interact with their patients. In addition, they decorate their offices and hospitals with bright colors and cartoons to make the environment-friendly to the child. They may also have toys, reading and writing materials, and videos for children. In addition, they use facilities and equipment that are specially designed for use by children.

Pediatric neurosurgeons work closely with another doctor to ensure that your child receives the best possible care. They make use of support services from nurses, pediatric physicians, nutritionists and others to ensure that your child has all the necessary care. This also ensures that the care provided is comprehensive and coordinated at the same time.

Conditions treated include:

Head deformities Spinal deformities Brain tumorsHead injuries Problems and injuries of the brain, spine or nerves Birth injuries (weakness of arms and legs) Hydrocephalus Intractable epilepsy Craniosynostosis Gait abnormalities (spasticity)Arachnoid cysts Spina bifida Brachial plexus injury also is known as obstetric brachial plexus palsy Movement disorders Cerebral palsy Craniofacial syndromes Chiari malformation Achondroplasia Congenital malformations of the brain and spine Vascular abnormalities Skeletal dysplasia

Common procedures include:

Biopsy: This is the removal of tissues for further examination under a microscope by a pathologist. A biopsy can be further classified into incisional biopsy where only a sample of tissue is removed, excisional biopsy whereby an entire suspicious area or lump is removed and needle biopsy where a sample of fluid or tissue is removed suing a needle.Stereotactical biopsy: This procedure maps the brain in a three-dimensional system. It is used together with CT and MRI scans to accurately target the area in question.Debulking: This is the surgical removal of a part of the tumor. It aims at decreasing the tumor burden on the surrounding structures.Gross total resection: This removes the entire tumor that is visible. This procedure is done when the pediatric neurosurgeon believes that the tumor can safely be removed without risk of unacceptable injury.Endonasal endoscopy: This is a minimally invasive surgical procedure that allows the neurosurgeon to remove lesions or brain tumors through the sinuses r nose.

Training

Pediatric neurosurgeons have at least 4 years of medical school, 1 year of internship, at least 5 years of residency in neurological surgery. They also have additional training in pediatric neurosurgery. Pediatric neurosurgeons diagnose and treat children from infancy to their adolescence. Their unique and advanced training make them highly qualified for their chosen profession.

Pediatric Orthopedics

What is Orthopaedics?

It is the medical specialty related to functional impairments or correction of deformities of the skeletal system, particularly the spine and the extremities, and related structures, as ligaments and muscles.

What is a pediatric orthopaedic surgeon?

A pediatric orthopaedist is the most experienced and best-trained physician to properly examine and treat musculoskeletal (muscle, bone, or joint) conditions in a child who is still growing. These are newborn infants through teenagers.

What type of training do pediatric orthopedic surgeons have?

Pediatric orthopedic surgeons are medical physician who have Graduated from an accredited orthopedic surgery residency programGraduated from an accredited medical schoolCompleted extra subspecialty training in pediatric orthopedics

Pediatric orthopedic surgeons treat kids from the infant stage through the teenage years. They prefer to make pediatric care the focus of their medical practice, and the unique nature of surgical and medical care of kids is learned from experience in practice and leading-edge training.

What kinds of treatments do pediatric orthopedic surgeons offer?

Pediatric orthopedic surgeons diagnose, treat, and take care of Kid's musculoskeletal issues, which include: Spine and limb deformities (like scoliosis and club foot)Broken bonesGait disorders (limping)Joint and bone infections

Popular conditions

The Pediatric Orthopaedic Surgery Service focuses on all areas of musculoskeletal care for newborns, kids, and teenagers. This experience consists of diagnosis and also a surgical and nonsurgical treatment for an array of issues like traumatic injuries, musculoskeletal diseases and skeletal deformities. Common conditions include:

Cerebral palsy, Limb length differences, Brachial Plexus Palsy, Scoliosis, Perthes disease, Sports injuries, Slipped Capital Femoral Epiphysis, Bowed legs, Blount’s disease, Knock Knees, Intoeing, Spondylolysis, Congenital Scoliosis, Spondylolisthesis, Fractures, Joint and bone infections, Growth plate fractures, Clubfoot, Hip dislocation-hip dysplasia.

Pediatric orthopaedic surgeons: Specialized care for kids

Kids aren’t just small adults. They cannot at all times say what is bothering them, or respond to medical questions, or be patient and cooperative at the time of a medical test. Pediatric orthopaedic surgeons are able to examine and treat kids in a manner to assist them to be calm and cooperative.

They as well value the concern, which goes with having a youngster with a musculoskeletal issue and they have expertise in interacting with nervous family members.

Many pediatric orthopaedic surgeons' offices are organized and themed with kids in mind. Reading materials, toys, specially designed equipment, and videos all assist in setting up a non-threatening and comfortable setting for the child.

Pediatric Cardiology

What is pediatric cardiology?

This is a subspecialty of cardiology that focuses on diseases and conditions of the heart and circulatory system which affect infants, children, and adolescents. Medical doctors who specialize in this specialty are known as pediatric cardiologists.

What conditions are treated?

Congenital heart defects Valvular heart disease, Heart failure, Coronary Sinus Atrial Septal Defects, Aortopulmonary Septal Defect, Electrophysiology, Coronary artery disease, Acquired Mitral Stenosis, Myocardial Infarction in Childhood, Patent Ductus Arteriosus (PDA)Ostium Secundum Atrial Septal Defects, Atrioventricular Node Reentry Supraventricular Tachycardia, Commotio Cordis, Bicuspid Aortic Valve, Anomalous Left Coronary Artery From the Pulmonary Artery, Coarctation of the AortaInterrupted Aortic Arch, Double-Chambered Right Ventricle, Congenital Mitral Stenosis, Partial Anomalous Pulmonary Venous Connection, Coronary Artery Fistula, Double Orifice Mitral Valve, Valvar Pulmonary Stenosis, Double Outlet Right Ventricle With Normally Related Great Arteries, Velocardiofacial Syndrome, Double Aortic Arch, Coronary Artery Anomalies, Double Outlet Right Ventricle With Transposition, Endocardial Fibroelastosis, Heterotaxy Syndrome and Primary Ciliary Dyskinesia, High Altitude Pulmonary HypertensionInfundibular Pulmonary Stenosis, Williams Syndrome, Junctional Ectopic Tachycardia, Muscular Ventricular Septal Defect, Ostium Primum Atrial Septal Defects, Pediatric Atrial Ectopic Tachycardia, Pediatric Atrial Flutter, Truncus Arteriosus, Ventricular Inversion, Pediatric Aortic Valve Insufficiency, Ventricular Septal Defects.

Devices used in pediatric cardiology

Stethoscope: This is an acoustic device which the pediatric cardiologist uses to listen to the internal sounds such as heart sounds. It can also be used to listen for bowel sounds, lung sounds and bruits (renal and carotid).

EKG calipers: This is a device used to measure intervals and also compare intervals on EKGs.

Pacemaker: This is an electrical device which is implanted to replace the natural pacemaker of the heart.

Defibrillator: This is an electrical device which alters the heart’s rhythm using electrical energy. It is used to top fibrillation of the heart.

Diagnostic tests and procedures

Echocardiogram: – a sound wave picture to check the structure and function of the heart.Ambulatory

ECG: This is a test, which is done during activity to look for any abnormal heart rhythms.

Exercise test: This is a test to measure if the heart is functioning well.

Cardiac Catheterization: This test involves placing a small tube (catheter) in or near the heart for closer observation. It can also e used to relieve the blockage.

Blood tests: This includes testing the levels of cholesterol, Creatine kinase, and Troponin .

Echocardiography (echo): This test inspects the heart’s chambers and blood flow.

Transthoracic echocardiogram (TTE): This is an echocardiogram of the heart via the thorax. It is a noninvasive procedure and takes a short time.

Transesophageal echocardiogram (TEE): This is an echocardiogram of the heart through the esophagus. It can require general anesthesia or sedation.

Cardiovascular magnetic resonance imaging (CMR): An MRI of the heart utilizes the ECG to observe specific mechanical functions of the heart.

Auscultation: This test involves listening to sounds such as heart sounds using a stethoscope.

Electrocardiography (ECG or EKG): This test measures the electrical activity of the heart using electrodes which are placed on the skin

Pediatric Rehabilitation

What is pediatric rehabilitation?

Pediatric rehabilitation is a subspecialty of medicine that focuses on enhancing and restoring the functional ability to children with various impairments or disabilities.

Which doctors offer pediatric rehabilitation services?

Pediatric rehabilitation services are offered by pediatric physiatrists. They are physicians who have specialized in the rehabilitative care and medical management of infants, children, and adolescents who have an array of medical conditions such as spinal cord injuries, brain injuries, musculoskeletal and neuromuscular disorders and conditions.

Why choose pediatric rehabilitation for your child?

Pediatric physiatrists are specially trained on how to deal with children. In addition to special medical skills, they possess the knowledge on how to treat and manage physical and cognitive disabilities which affect growth and development of children.

They decorate their offices, outpatient centers, and hospitals with bright colors and interesting items to the children. This helps them to feel more comfortable and relaxed so that they can undergo care with the least fuss possible.

What are the benefits of pediatric rehabilitation?

This rehabilitation specializes on providing comprehensive and coordinated medical care for children who have injuries such as spinal cord injuries and spina bifida.It educates family members on how to care for and support children undergoing pediatric rehabilitation.The team of doctors and healthcare professionals rotate and combine their skills to provide the best possible care for the children.Specialists are involved in consultations and recommendations about tone managementThe care given enables the child to have optimal function with their skillsThe care given is tailored to suit your child’s individual needs.It promotes daily life independenceIt reduces complications that may arise due to lack of rehabilitationIt maintains continuous and progressive care to overcome fragmentationIt provides follow-up assessments and developmental evaluationsIt enhances the patient’s and family’s lives

Conditions treated

Cerebral palsy, Spina bifida, Brain injury, Brachial plexus palsy, Stroke, Spinal cord injuries, Gait abnormalities, Neuromuscular disorders, Limb deficiencies, Musculoskeletal conditions, Genetic abnormalities, Developmental disabilities.

Primary medical team members include:

Pediatric Physiatrist

Pediatric Physical Therapist

Pediatric Orthopedic Surgeon

Pediatric Occupational Therapis

Pediatric surgery