The gift of life is wondrous. The joy, that bringing new life into this world, knows no bounds. From conception to birth, raising and nurturing, a child brings the ultimate fulfillment to a person’s life. Every parent wishes for a strong, healthy offspring, and thankfully that is the case with the vast majority of parents.
Sadly, that is not always the reality of life. In a small percentage of births, the cruelties of nature will play an adverse hand and a baby will be born with health problems. Similarly, as a child grows and develops health issues can emerge. For the most part, these problems are minor, and with medical care are soon corrected. But, for the very few, the health problems may not be so straight forward and can necessitate surgery.
Surgery on newborn babies and young children is a very specialist area of the medical profession. With this in mind, Samitivej Hospital has created a dedicated unit specializing in surgical procedures on the very young. The Newborn and Pediatric Surgery Center at Samitivej Hospital is now unequalled in its singular approach to this one, highly specialized, area of medical care.
Samitivej hospital’s Newborn and Pediatric Surgery Center has been designed with the child in mind, from the ground up. It exudes an atmosphere which is conducive to the young, helping to reduce anxiety and stress. The staff are all highly trained, and so tuned in to the young psyche, they are able to make young children feel almost home from home.
At this specialized center they exploit all the most advanced technology in pediatric minimally invasive surgery (MIS) otherwise referred to as laparoscopic surgery. Although this form of surgery employs the very latest in cutting edge technology, it was in fact first performed on a human patient by Hans Christian Jacobaeus in 1910 following the successful use of the technique on animals by Georg Kelling in 1901.
Although laparoscopic procedures in adults and children do bear many similarities, specialist pediatric knowledge is required. Particular skills are required when operating on young patients due to the anatomic and physiologic differences between the mature body and that of a developing one.
Why Laparoscopic Surgery?
MIS, or laparoscopic surgery is now an advanced, highly versatile and effective way of operating on a patient, particularly in the very young. The technique allows for an incision to be extremely small compared to that seen with conventional surgery. This vastly reduces the operative trauma on the patient, particularly important in the very young, whilst also reducing the recovery period.
This will in turn reduce the time spent in hospital. An extended stay in hospital can mean that a child is separated from one or both of it parents for long periods, that is stressful for any child and its parents. A further advantage with laparoscopic surgery is the reduced level of scaring. With an incision being just a few millimeters in size, the eventual visible scaring is minimal, good news for any child as they grow into a self-conscious teen.
Just as with more conventional surgery, the child will most likely have to refrain from eating and drinking several hours before the procedure is undertaken. The first part of the procedure is to give the child a general anesthetic which puts them to sleep. The child will sleep through the entire procedure and will feel no pain or discomfort.
Via the first small incision the child’s abdomen is filled with carbon dioxide gas (CO2). This has the effect of raising the abdominal wall to become domelike. This gives the surgeon a clear view of the abdominal and pelvis area. The surgeon can the easily inspect organs such as the uterus, ovaries and bladder. Inflating the abdominal cavity also gives the surgeon more space in which to operate.
The second small incision allows the surgeon to insert the laparoscope, or camera, which act as the eyes for the entire procedure. A third or fourth incision may then be made to allow access for additional surgical instruments, dependent upon the exact nature of the procedure.
On completion of the procedure the CO2 is removed as are the surgical instruments. Some CO2 may remain within the body but this will be absorbed and expelled through the body’s natural functions. The small incisions can then be closed using dissolving stitches or stristrips. The child can be moved to recovery until the anesthetic wears off and the child wakes up.
The Versatility of Laparoscopic Surgery
With its success, MIS has never stopped evolving, in fact it is an area of medicine that has benefited immensely from modern technology. The development of tiny cameras attached to a laparoscope with images of inside the body being viewed on a screen by the surgeon, and the introduction of lasers, has meant that laparoscopic procedures are many and varied.
Most, if not all, routine surgical procedures, such as an appendectomy, are now done via MIS. This facilitates a shorter stay in hospital whilst minimalizing the disruption to day to day life for the parents. Other common procedures include hernia repair cyst and tumor removal. Urologic, orthopedic and thoracic procedures are also routinely and successfully carried out via MIS at the Newborn and Pediatric Surgery Center.
Diagnostics with Laparoscopes
Laparoscopic procedures are not onlysuitable for repair and removal of damaged or malfunctioning parts of the body, they are also a vital tool in diagnostics. The whole of the abdominal and pelvic area lends itself to laparoscopic diagnostics. The procedure allows for fast and accurate diagnosis of many health issues associated with this part of the body.
For diagnostic purposes the surgeon would usually only need to make 2 small incisions. As with laparoscopic surgery, the first incision will be to inflate the abdominal cavity with CO2. The second to accommodate the laparoscope, the surgeon’s eyes. The surgeon can then view the whole of the abdominal region and its organs for a fast and accurate diagnosis.
The Newborn and Pediatric Surgery Center at Samitivej Hospital are now leading exponents of laparoscopic procedures, both surgical and diagnostic. They maintain the very highest of standards along with an innovative approach to child health care through their exceptionally skilled surgical team and support staff.