Pediatric Surgery

Pediatric surgery is a specialized surgical branch that deals with the diagnosis and treatment of surgical diseases occurring in children from the neonatal period to the end of adolescence. Children are not small copies of adults; their anatomical structures, physiological processes, and responses to diseases differ from those of adults. For this reason, pediatric surgery is a highly delicate field of expertise that requires unique knowledge and experience. The Koru Hospital Department of Pediatric Surgery offers the best surgical care to our little patients with its experienced specialist staff and child-friendly approach.

What Does Pediatric Surgery Deal With?

Pediatric surgery specialists deal with congenital anomalies, trauma, tumors, infections, and other conditions requiring surgery. This specialty serves a wide spectrum ranging from neonatal surgery to adolescent surgery. Pediatric surgeons plan surgeries by considering the child's growth and development process and prefer surgical methods that will cause the least trauma to the child.

Conditions requiring surgical intervention in children show different characteristics than in adults. For example, while congenital anomalies that appear in the neonatal period may require emergency surgical intervention, some conditions may resolve spontaneously as the child grows. Making this distinction correctly requires deep expertise and experience in the field of pediatric surgery.

Common Diseases in Pediatric Surgery

Congenital Anomalies

• Inguinal hernia: It is one of the most common conditions in childhood requiring surgical intervention. It is seen more frequently in boys and is usually noticed by a swelling in the groin area.
• Umbilical hernia: It is a hernia that occurs in the navel area; small ones usually close on their own. Large or non-closing hernias may require surgical intervention.
• Undescended testis (cryptorchidism): It is the condition where the testis has not descended into the scrotum. Early surgical correction reduces future fertility problems and tumor risk.
• Hypospadias: It is a condition in boys where the urinary tract opening is not in its normal position. Successful results are achieved with surgical correction.
• Congenital intestinal obstructions: These are serious conditions that require emergency surgery in the neonatal period. Early diagnosis and intervention are life-saving.
• Esophageal atresia and tracheoesophageal fistula: These are congenital connection anomalies between the esophagus and the trachea, requiring surgical intervention in the early postnatal period.

Abdominal Diseases

• Acute appendicitis: It is the most common condition in childhood requiring emergency surgery. It is characterized by abdominal pain, nausea, and fever. Early diagnosis and treatment prevent complications.
• Intussusception: It is the condition where one part of the intestine slides into another. It is especially common between 6 months and 3 years of age and requires emergency intervention.
• Meckel's diverticulum: It is a congenital intestinal anomaly that can cause bleeding, obstruction, or infection.
• Pyloric stenosis: It is the narrowing of the stomach outlet, usually manifesting as projectile vomiting in the first weeks of life. Complete recovery is achieved with surgical treatment.

Other Surgical Conditions

• Childhood tumors: Surgical treatment of solid tumors such as Wilms tumor, neuroblastoma, and hepatoblastoma is within the scope of pediatric surgery.
• Trauma: Surgical treatment of abdominal and chest traumas, burns, and other injuries in children is performed.
• Gastroesophageal reflux: Surgical intervention may be required in severe cases of reflux that do not respond to medical treatment.
• Biliary tract diseases: Gallstones and congenital biliary tract anomalies may require surgical treatment.

Diagnostic Methods

Making an accurate diagnosis in the field of pediatric surgery forms the basis of the treatment plan. The main diagnostic methods used in the evaluation of pediatric surgery patients at Koru Hospital are as follows:

• Physical examination: A detailed physical examination by an experienced pediatric surgeon is the first and most important step in diagnosis.
• Ultrasonography: It is a radiation-free, painless, and repeatable imaging method. It is the preferred first-line imaging method in children.
• Direct radiography (X-ray): Used in the evaluation of intestinal obstruction, foreign body ingestion, and chest diseases.
• Computed tomography (CT): Provides detailed imaging in complex cases and tumor evaluation.
• Magnetic resonance imaging (MRI): Offers superior image quality in soft tissue evaluation and does not contain radiation.
• Laboratory tests: Blood and urine tests, infection markers, and tumor markers assist in diagnosis.

Treatment Methods

Modern pediatric surgery is going through a period where minimally invasive surgical methods are at the forefront. The Koru Hospital Department of Pediatric Surgery determines the most appropriate treatment method by considering the child's well-being at the highest level.

• Laparoscopic surgery: These are surgeries performed through small incisions with the help of a camera and special instruments. It provides less pain, shorter hospital stays, and better cosmetic results.
• Open surgery: In some cases, a traditional surgical approach may be required. Experienced surgeons aim to achieve the best result with the smallest incision.
• Endoscopic interventions: Endoscopic methods are used for foreign body removal, biopsies, and some treatment procedures.
• Day-case surgery: Discharge on the same day is possible in suitable cases. This approach reduces the child's stress caused by the hospital environment.

When Should You Take Your Child to Pediatric Surgery?

It is recommended to take your child to a pediatric surgery specialist in the following situations:

• When a swelling or mass is noticed in the groin or navel area
• When there is severe and persistent abdominal pain
• When there is vomiting, abdominal swelling, or defecation problems in a newborn
• When the testes are not palpable or are not in their place
• When an anomaly of the urinary tract or genital area is noticed
• When complaints develop after trauma to the abdominal or chest area
• In case of foreign body ingestion
• When an abnormal mass or swelling is noticed in any part of the body
• In cases where a congenital anomaly has been diagnosed or is suspected

Neonatal Surgery

Neonatal surgery is one of the most delicate and challenging sub-branches of pediatric surgery. Conditions requiring surgical intervention immediately after birth or in the first weeks require an experienced team and a specially equipped neonatal intensive care unit. Congenital anomalies such as esophageal atresia, diaphragmatic hernia, intestinal atresias, gastroschisis, and omphalocele are the main conditions requiring emergency surgical intervention in the neonatal period.

Success in neonatal surgery is directly related to the quality of the anesthesia team and the intensive care unit, as well as the surgeon's experience. At Koru Hospital, a coordinated team consisting of a pediatric surgeon, neonatologist, pediatric anesthesiologist, and neonatal intensive care nurses works on cases requiring neonatal surgery. In cases of congenital anomalies diagnosed in the prenatal period, birth planning is carried out to ensure that the baby is born under the most appropriate conditions and that the necessary surgical intervention is performed in a timely manner.

Child-Specific Approach in Urological Surgery

Urological surgery in children is an important component of pediatric surgery. Conditions such as vesicoureteral reflux, ureteropelvic junction obstruction, bladder dysfunction, and kidney stones are frequently encountered urological problems in children. In the treatment of these diseases, the best functional and cosmetic results are aimed at by using surgical techniques appropriate for the child's age and development. Especially in reconstructive surgeries such as hypospadias repair, the experience of the pediatric surgeon plays a decisive role in terms of long-term results.

Family-Centered Approach in Pediatric Surgery

The treatment process in pediatric surgery involves not only the child but the entire family. At Koru Hospital, families are informed and involved in the process at every stage, from pre-surgery to post-discharge. To reduce the child's pre-surgery fears, age-appropriate explanations are provided, and a child-friendly environment is ensured.

Detailed instructions are also given to families during the post-operative care process. Comprehensive information is provided regarding wound care, nutritional recommendations, activity restrictions, and follow-up appointments. Our pediatric surgery team is always accessible to answer families' questions and alleviate their concerns.

Anesthesia and Pain Management in Pediatric Surgery

Anesthesia application in children shows significant differences from adults. The anesthesia plan is created individually according to the child's age, weight, and general health status. At Koru Hospital, experienced anesthesiologists work in pediatric surgeries, and child-specific anesthesia protocols are applied. In post-operative pain management, a comfortable recovery process is aimed at by using analgesic protocols appropriate for the child's age. Post-operative pain is minimized with regional anesthesia techniques, patient-controlled analgesia, and multimodal pain management approaches.

Day-case surgical practices significantly reduce the stress of both the child and the family by shortening the time children spend in the hospital. Many surgeries such as inguinal hernia, umbilical hernia, undescended testis, and circumcision can be performed safely as day-case procedures.

Why Koru Hospital Pediatric Surgery?

• Expert staff: Services are provided by experienced and competent specialists in the field of pediatric surgery.
• Child-specific approach: Every child is unique, and the treatment plan is created individually.
• Minimally invasive surgery: Laparoscopic and endoscopic methods are preferred whenever possible.
• Multidisciplinary team: Pediatric surgeons work in coordination with pediatric anesthesiologists, pediatric intensive care specialists, and other branches.
• Child-friendly environment: The hospital environment is arranged in a way that children will feel comfortable.
• Family communication: Transparent and open communication is established with families at every stage of the treatment process.

In the Pediatric Surgery department of Koru Hospital, our specialist physicians combine superior surgical experience and modern medical technologies for the health of our smallest patients. You can apply to our pediatric surgery outpatient clinic for any health problem of your child that requires surgical evaluation.