Sir Ganga Ram Hospital, New Delhi, India

Paediatric Surgery

Introduction

The surgery of newborn, infants and children

-The aim of Paediatric Surgery in India is to set standards, not to create a monopoly

Paediatric Surgery deals with the surgical care of newborn babies, infants and children to the age of 18 years. This branch is highly specialized, not only because one has to handle very delicate and miniature tissues, but also because it requires a great deal of patience, compassion and understanding to handle the little babies and their very anxious parents.

Children are not miniature adults and hence, require experienced and highly qualified personnel that can cater to their needs. Babies suffer from diseases and surgical conditions which are different from adults. Also, their physiology is different and they handle surgical stress differently. The principles of surgical management in children are entirely different from adults.

The Department of Paediatric Surgery at Sir Ganga Ram Hospital, New Delhi, is at the forefront among centers that provide comprehensive surgical care to children, including tertiary care. The department was established in 1980 and was one of the earliest centers in private sector in North India. The faculty comprises of very experienced surgeons in the speciality. A team of doctors including Senior Paediatric Surgeon, post-graduate senior resident and the trainee resident doctors provide comprehensive surgical care to the children round the clock.

Dr Rajeev Kulshrestha is the Chairman and Head of the Department of Paediatric Surgery. He is an eminent Paediatric Surgeon with more than thirty years of experience in the speciality. Dr Alpana Prasad, Senior Consultant has an experience of more than 15 years and has special interest in Newborn Surgery, Paediatric Urology and Minimal Access Surgery in children. Dr Tripta Dutta and Dr Shalini Agarwal are the other senior faculty members in the Department and are taking active interest in the departmental activities. The Department is accredited by the National Board of Examinations for the super-speciality training in Paediatric Surgery. Besides clinical care and teaching, the department is actively engaged in research, relevant to clinical care of the infants. The faculty participates in international and national conferences and has published several papers in international journals, written books and chapters in the textbook of Paediatric Surgery.

The department has been providing comprehensive, state-of-the-art surgical care in children, ranging from operations in newborns to various sub-specialties of Paediatric surgery. On an average the department performs more than 1000 operations in a year of varying complexity and magnitude. The operative results are comparable to the best centers in India and abroad.

The department undertakes all kinds of operations in children. These include:

Common Operations - Conditions like inguinal hernia, hydrocele, and undescended testis are very common in children. These conditions require surgical intervention. The results are excellent if done by an experienced Paediatric surgeon. These operations are usually done as day-care surgery.

Neonatal Surgery - Some of the congenital defects in newborn, if not corrected immediately after birth, will result in death viz. congenital diaphragmatic hernia, esophageal atresia with tracheo-esophageal fistula, neonatal intestinal obstruction and anorectal malformations (imperforate anus). Some anomalies require very aggressive preoperative care so that the baby is in an optimal condition for operation viz. abdominal wall defects. Other birth defects include spina bifida and hydrocephalus. All kinds of emergency and elective surgeries in the newborn babies (even those who are premature and very high-risk) are being performed in our department routinely with excellent results. Antenatal diagnosis by maternal ultrasonography has given another dimension for better newborn care by early postnatal referral for surgical intervention in relevant cases.

Paediatric Thoracic Surgery - Anomalies of Lung viz. congenital lobar emphysema, congenital cystic adenomatoid malformation of the lungs, cyst in the lungs, bronchogenic cyst and mediastinal masses, are being routinely operated. We also perform bronchoscopies in children to remove inhaled foreign bodies from the air passages. Thoracotomy and decortication is being done successfully in the department for chronic empyema. We are doing VATS (video assisted thoracoscopic surgery) in children.

Paediatric Urology - Abnormalities of the kidneys and bladder account for 35-40% of surgical cases in children. Operations are done for both congenital and acquired clinical conditions of the kidneys, ureters, bladder and urethra in children including in newborn as well as older children.

These operations are done for conditions like hydronephrosis, vesicoureteral reflux and posterior urethral valves. Some of these operations are done endoscopically using a cystoscope. We are routinely performing cystoscopy and cystoscopic procedures in newborn babies too, besides doing these in older children.

Paediatric Gastrointestinal Surgery - Complicated operations on the gastrointestinal system, liver and bile ducts are routinely undertaken. These are done for conditions like imperforate anus, hirschsprung's disease, biliary atresia, choledochal cyst among others.

Paediatric Cancers - The department undertakes surgical treatment of childhood solid tumors like Wilms' tumor (tumor of the kidney), neuroblastoma, rhabdomyosarcoma, teratoma, lymphoma, etc.

Paediatric Plastic Surgery - Plastic reconstruction in childhood deformities like cleft lip, cleft palate and hypospadias and epispadias repair are routinely undertaken with excellent results.

Paediatric Laparoscopy -Laparoscopy for diagnosis and laparoscopic surgical procedures are being performed routinely in our department. 

Future Plans -

  1. Community service and outreach clinics in remote areas.
  2. Fetal surgery
  3. Stem-cell therapy in Paediatric surgical practice.

Photo Gallery:


Oesophageal atresia with TOF


Spina Bifida


Cong.Diaphragmatic henia Rt


Congenital Lobar Emphysema


Abdominal Wall Defects


Wilm's Tumour


Hypospedias


Hirschsprung's Disease


Anorectal Malformation


Ileal Atresia


Sacrococcygeal Teratoma


Hydrocephalus