NEWBORN SURGERY

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A ‘neonate’ is a baby less than one month old. Neonatal or newborn surgery is at the heart of pediatric surgery and constitutes some of most technically demanding surgeries that pediatric surgeons are trained to do.

Most ailments that require neonatal surgery are for congenital deformities, in other words, those deformities that are formed ‘in-utero’ and are present at birth. Some of these defects can be detected by maternal scans done during pregnancy, giving the family an opportunity to meet with a pediatric surgeon and prepare for the baby’s surgery after birth.

After birth, the baby is stabilized in a neonatal intensive care unit (NICU) where further tests are done to confirm the diagnosis. A few examples of life threatening congenital defects are esophageal atresia, trachea-esophageal fistula, duodenal atresia, intestinal atresia, imperforate anus (anorectal malformations), sacro-coccygeal teratoma, congenital lung malformations, congenital diaphragmatic hernia etc. Usually, these malformations are operated upon within a few days of birth once the diagnosis is confirmed and the baby has been stabilized in the NICU. The timing of surgery may vary depending upon the diagnosis and associated defects a baby may have.

Surgery is done under anesthesia, administered by an anesthesiologist trained in pediatric anesthesia. Some babies may be candidates for laparoscopic surgery and the pros and cons of open vs. laparoscopic surgery may be discussed with your surgeon. After surgery, the neonate may need to stay in the NICU for varying periods of time during which antibiotics, intravenous nutrition and other supportive measures may need to be administered. The fine tuning of the post operative care in a NICU is done by a neonatologist, a pediatric specialist for neonates, who works along with the surgeon to nurture the baby during the recovery process.

After discharge from the NICU, depending on the nature of the disease, the baby may need follow-up with a pediatric specialist, apart from the surgeon for extended periods of time. Though the first few weeks of life might be eventful for a baby with a congenital malformation, most neonates do have a good outcome once recovery is complete.