General pediatric surgery:

It is important that you be honest with your child. In a non-threatening way, being careful not to use words that will make the general peadiatric surgery sound scary. Let your child know what's going to happen. Make your explanation age-sensitive. Don't overwhelm a younger child with detailed (and scary) explanations. Remember to tell your child that you will be close to him throughout the entire hospital visit. Children often feel much less apprehensive when they know they're not going to be left alone.

Division of General Surgery

The Division of General Surgery diagnoses and treats surgical conditions in infants, children, and adolescents. Typical diagnoses include inguinal hernias, umbilical hernias, pyloric stenosis, undescended testes, and appendicitis. Congenital and acquired lesions of the head and neck, chest, abdomen, gastrointestinal tract, and endocrine organs as well as skin lesions are frequently seen in our clinic.

The Division is staffed by physicians who are certified by the American Board of Surgery with special competence in pediatric surgery whose areas of expertise range from gastrointestinal diseases (i.e., gastroesophageal reflux, inflammatory bowel disease, and gallbladder disease) to tumors, newborn surgery (including the neonatal Extracorporeal Membrane Oxygenation Program [ECMO]), laparoscopy, and thoracoscopy. Fetal consultations and child abuse consultations are also provided through our general surgery service. Twenty-four-hour pediatric surgical care is available through duPonts Emergency Room.

Common pediatric diseases that may require pediatric surgery include:

• Congenital malformations
• Lymphangioma
• Cleft Lip and palate
• Esophageal atresia
• Tracheoesophageal fistula
• Hypertrophic pyloric stenosis
• Intestinal atresia
• Necrotizing enterocolitis
• Meconium Plugs
• Hirschsprung's disease
• Imperforate anus
• Undescended testes
• Abdominal wall defects: omphalocele, gastroschisis, hernias
• Chest wall deformities: pectus excavatum
• Childhood tumors: like neuroblastoma, Wilms' tumor, rhabdomyosarcoma, ATRT, liver tumors, teratomas
• Separation of conjoined twins

Services Available:

• Diagnosis of pediatric surgical conditions
• Treatment of pediatric surgical conditions
• Fetal consultations
• Pediatric trauma evaluations
• Twenty-four-hour surgical coverage

FAQs General Pediatric Surgery

How much should I tell my child beforehand about surgery?

It is important that you be honest with your child. In a non-threatening way, being careful not to use words that will make the surgery sound scary. Let your child know what's going to happen. Make your explanation age-sensitive. Don't overwhelm a younger child with detailed (and scary) explanations. Remember to tell your child that you will be close to him throughout the entire hospital visit. Children often feel much less apprehensive when they know they're not going to be left alone.

Can my child have two different procedures done (by two doctors at the same time)?

Yes, it is possible for more than one procedure to be accomplished at the same time, as long as it is considered to be safe for the child. It is also possible for more than one surgeon to perform the procedures.

Do you perform any plastic surgery?

The pediatric surgeons always perform plastic surgical techniques to make certain that patients have the best cosmetic results possible, and do perform some plastic surgical procedures. They do not perform complex reconstructive surgery.

What is a hernia?

An inguinal hernia is an opening in the muscle of the groin in which a portion of the intestine (or ovary, in girls), can pass through. It may be large or small, and usually appears as a lump or swelling in the groin or scrotum in boys, or in the labia in girls. An umbilical hernia develops when the muscles in the abdomen (around the belly button) do not fully close before birth, and some intestine protrudes into the opening.

Will the operation and treatment for a hernia make my son sterile?

No. The operation is a perfectly safe operation and will not cause a male to become sterile. In fact, fixing a hernia prevents it from becoming stuck, which in turn prevents damage to the testicle.

How long will my child be in the hospital after surgery?

If your child is having an outpatient procedure, he or she will probably be in and out of the hospital in the same day. For inpatient procedures, the length of stay varies, depending on the procedure and your child's rate of recovery. If your child has major abdominal or thoracic (chest) surgery, he will probably be in the hospital for five to seven days. If he follows the doctors' and nurses' postoperative instructions closely, he will most likely go home sooner. Length of stay often varies from child to child, so be sure to ask your surgeon about the timeline for your child's visit.

How much pain will my child have after surgery?

Your child may experience soreness for one to two days after a common outpatient procedure such as a hernia operation. The doctor may give him a regional nerve block or caudal block during the procedure while he or she is asleep, and then prescribe pain medication for him to use after the surgery. Parents are often surprised at how quickly their children recover after an outpatient procedure. Keeping your child quiet and restful may become the real challenge!. For inpatient procedures, the surgeon and anesthesiologist will develop a pain treatment plan for your child together. They may give your child a patient-controlled analgesia pump or a postoperative epidural catheter. These therapies allow your child to determine exactly how much pain medication is used, and enables him to access that medication almost immediately.

When can my child resume full activity?

This depends primarily on the procedure being performed. Be aware that recovery timelines can vary from child to child. Your child's doctor will be able to give you specific information about when your child can go back into action.

How soon after surgery may I see my child?

You may see your child when the medical team determines that he is in a stable condition in the recovery room or the Post-Anesthesia Care Unit (PACU). You can usually see your child approximately 30 to 45 minutes after surgery, which is when they are usually just becoming aware of where they are.

What sort of dietary restrictions will my child need to follow before and after the surgery?

The medical staff will give you detailed instructions outlining what your child will and will not be able to eat before and after the surgery. The factors vary greatly depending on local factors.

When can my child return to school?

The length of time your child will need to wait before returning to school will vary depending on the type of surgery and your child's response to it. Your child's discharge instructions will usually note the date your child may return to school.

When can my child take a bath?

For most operations, children may bathe after 48 hours. For tonsil removal and ear tube insertion procedures, it is important that your child does not allow any water to enter his ears. Some ear tube and tonsil patients may shower after 24 hours, although some are encouraged to wait until their return visits.

Will my child vomit after the operation?

Vomiting is a possible side effect of anesthesia, but does not happen frequently. All of the anesthesiologists at Nemours are pediatric anesthesiologists, and therefore are trained to make the anesthesia experience as comfortable as possible for your child. Their child-centered expertise, coupled with the use of new anesthetic agents and anti-nausea medications, will greatly reduce your child's risk of vomiting after surgery.

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