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Paediatric Surgery

Introduction

Pediatric surgery is a specialized field of surgery for the treatment of conditions that can be surgically corrected in a baby, child, or adolescent.
The purpose of pediatric surgery varies with the procedure. In general, the purpose is to surgically correct a congenital condition, disease, traumatic injury, or other disorder in the pediatric patient.
Pediatric surgery is the surgical branch that uses operative techniques to correct certain pediatric conditions (i.e., congenital abnormalities, tumors, chronic diseases, and traumatic injuries). There are different specialties within the field.
The pediatric surgeon must take into account the special requirements unique to the young surgical patient. The pediatric surgeon is trained to treat the entire spectrum of surgical illnesses. The following is an overview (with symptoms) of the more common pediatric conditions that require surgery typically performed by the pediatric surgeon.

Types of Pediatric Surgery

Pediatric surgery is the medical specialty concerned with the surgical treatment of infants, children and adolescents. Pediatric surgeons are the healthcare providers responsible for carrying out these procedures after crafting a pre-operative plan based on the patient's findings. The surgery may be divided into several different areas of expertise.
Surgeries in the pediatric population may be arbitrarily divided into major, minor, elective and urgent surgeries. Surgeries of the head and neck, as well as the chest and some abdominal operations, fall under the auspice of major surgery.
Minor pediatric surgeries are considered to be procedures that allow children to return to their everyday lives within a relatively quick period postoperatively. These surgeries may be done on an outpatient basis with children being allowed to go home the very same day or the one thereafter. Major complications are also very rare following minor surgeries. The removal of excess skin, biopsies and the correction of long bone fractures may all be considered minor surgical operations.
When a child does not necessarily need an urgent surgery, for example circumcision in boys, it is referred to as elective surgery. This means that surgeons may conduct the surgery on later dates and may take into account the wishes of the parents and guardians.
Major surgeries tend to be very complex and may be associated with increased risks in addition to a longer recovery period and hospitalization. For instance, the removal of central nervous system tumors or the reparation of congenital heart defects may be included in this category of pediatric surgeries. Also included are the correction of skull malformations, spinal anomalies and pulmonary, gastrointestinal and serious physiological anomalies.

Risk Factors

Risk factors include:

  • Surgical management was performed in the setting of a short hospitalization. Patients were hospitalized the day before or the morning of surgery for scheduled procedures. Patients with a supracondylar fracture of the elbow underwent surgery 6 to 12 hours after injury. Fracture of the femur was considered a relative emergency and all patients underwent surgery within 24 to 48 hours. Postoperative hospital stay was often short, on average 2 to 4 days if there were no complications.
  • All procedures were conducted in an operative room reserved for non-septic paediatric surgery.
    The preoperative protocol was washing the operative site with an antiseptic solution (Asepsil), followed by a first disinfection with a 10% iodine-polyvidone solution then a second disinfection by the surgeon just before positioning the operative drapes. The disinfected limb was held in a sterile jersey just before incision.
  • The frequency of postoperative infection defined as the number of infected patients divided by the number of operated patients, and the frequency of wound infection, defined as the number of sites infected divided by the number of operated sites.
  • Pediatric dermatologic surgery is performed every day by more and more pediatric dermatologists. These procedures must be tailored to both the child and parent. Special conditions for children and required when considering details about the surgical personnel, consultation, operating room and postoperative care. Data on specific risks, both anesthetic and surgical, are sparse and analysis of risk factors for specific complications are lacking. This information would be helpful for both parents and dermatologic surgeons performing these procedures.
  • children's surgery centers and may not be nationally representative of all pediatric surgery in the United States. These findings, along with internal analysis of hospital-specific data, will help inform quality improvement measures to decrease readmission rates in pediatric surgery.

Procedure

Procedure include:

  • This is a list of the most common procedures we perform every day. If you do not see your child’s procedure listed, please contact us. Our specialists can perform most outpatient pediatric surgeries.
  • Nasal Endoscopy with culture: A small viewing tube inserted into the nose to allow doctors to obtain culture samples and evaluate conditions. Our endoscopes are made specifically for pediatric use, and patients are asleep for this procedure.
  • Nasal Endoscopy with cautery: A small endoscopic tube is inserted into the nose and the affected area is cauterized to reduce or eliminate chronic nosebleeds.
  • Tonsillectomy and Adenoidectomy: The surgical removal of the tonsils and adenoids.
  • Removal Impacted Cerumen: The removal of impacted ear wax. Children are asleep for this procedure.
  • Umbilical hernia repair: A procedure to correct an umbilical hernia, which occurs when tissue pushes through a hole in the abdominal wall at the belly button.
  • Pilonidal cyst: The draining or removal of a small cyst located at the end of the tailbone. Children may be asleep for this procedure.

Range of Treatment Cost

Procedure Duration In Hospital Min Cost (INR) Max Cost (INR)
Cystic hygroma 10 202365₹ 400000₹
Esophageal Atresia Depends upon the treatment 239840₹ 539840₹
Tracheoesophageal Fistula Depends upon the treatment 314790₹ 614790₹
Hypertrophic Pyloric Stenosis 8 314790₹ 614790₹
Intestinal Atresia Depends upon the treatment 359760₹ 559760₹
Necrotizing Enterocolitis Depends upon the treatment 71202₹ 101202₹
Meconium Plugs Depends upon the treatment 93687₹ 103687₹
Hirschsprung's Disease Depends upon the treatment 116172₹ 156172₹
Imperforate Anus Depends upon the treatment 232345₹ 432345₹
Undescended Testes Depends upon the treatment 187375₹ 387375₹
Omphalocele Depends upon the treatment 127415₹ 167415₹
Gastroschisis Depends upon the treatment INR 60 per follicle INR 80 per follicle
Hernias 12 119920₹ 189920₹
Chest Wall Deformities  Depends upon the treatment 176132₹ 276132₹
Neuroblastoma  Depends upon the treatment 127415₹ 327415₹
Wilms' tumor Depends upon the treatment 203189₹ 403189₹
Rhabdomyosarcoma Depends upon the treatment 178381₹ 378381₹
Liver Tumors Depends upon the treatment 136034₹ 436034₹
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