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The Pediatric Surgeons perform a wide variety of surgical procedures
in the following categories (lists are inclusive but not entirely
exhaustive):
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Trauma
- The Pediatric Surgery service is consulted immediately for any
pediatric trauma victim with serious and/or multiple injuries,
including burns. The service will coordinate the trauma work-up,
consult the appropriate subspecialty services, perform any necessary
general surgical procedures, and coordinate care in the hospital. The
service maintains a constant presence and therefore, is an easily
recognizable source of information for families and caretakers.
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Tumors/Oncology
- The Pediatric Surgery service is intimately involved with the
management and performs surgery for surgical childhood malignancies.
These include Wilms' tumor, neuroblastoma, hepatoblastoma,
hepatocellular carcinoma, rhabdomyosarcoma, teratomas, adrenal tumors,
ovarian tumors, and testicular tumors. In addition, the service is
involved in performing biopsies for the staging of non-surgical
malignancies and performs vascular access procedures for children who
will require long-term chemotherapy.
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Transplantation
- The Pediatric Surgery service, in conjunction with Pediatric
Urology, performs kidney transplants and participates in the
comprehensive care of these pediatric patients. The service provides
necessary vascular access for children requiring bone marrow
transplantation. The service also provides dialysis access.
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Airway
- The Pediatric Surgery service utilizes laryngoscopy, bronchoscopy,
and appropriate surgical techniques to evaluate and treat a variety of
congenital and acquired airway disorders. These include stridor,
laryngomalacia, tracheomalacia, subglottic stenosis, tracheal stenosis,
laryngeal or tracheal clefts, and aspirated foreign bodies.
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Head and Neck
- The Pediatric Surgery service addresses a variety of conditions in
the head and neck including branchial cleft anomalies and remnants,
thyroglossal duct cysts, cystic hygroma/lymphangioma, abnormal/enlarged
lymph nodes, neck masses, dermoid and sebaceous cysts, torticollis,
disorders of the thyroid and parathyroid glands, and "tongue-tie".
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Lymph Node
- The Pediatric Surgery service evaluates and surgically treats
enlarged and infected lymph nodes when appropriate from a variety of
conditions which include infections (cat scratch, atypical
mycobacteria, tuberculosis, staphylococcus, streptococcus, and a
variety of other bacteria) , tumors (Hodgkin and non-Hodgkin lymphoma,
metastases from other primary tumors), and idiopathic enlargement.
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Endocrine
- The Pediatric Surgery service evaluates and treats disorders of the
thyroid gland, parathyroid glands, adrenal glands (adrenal tumors,
hyperfunctioning and hypofunctioning gland, pheochromacytoma), pancreas
(cysts and pseudocysts, hyperinsulinism, islet cell adenoma,
tumors).
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Breast
- The Pediatric Surgery service evaluates and treats benign lesions
of the breast in males (gynecomastia, breast enlargement, infection,
congenital anomalies) and females (fibroadenoma, infection,
inflammation, cysts, congenital anomalies). Endocrine evaluation is
obtained when needed.
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Chest Wall
- The Pediatric Surgery service evaluates and treats disorders of the
chest wall including pectus excavatum, pectus carinatum, sternal
defects, Poland's syndrome, and other congenital and acquired
deformities. Cardiac and pulmonary evaluation is obtained when
appropriate.
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Thoracic
- The Pediatric Surgery service evaluates and treats a variety of
congenital and acquired thoracic disorders. These include congenital
diaphragmatic hernia, diaphragmatic eventration, mediastinal cysts and
tumors, bronchogenic cysts, enlarged lymph nodes, pulmonary
sequestration, cystic adenomatoid malformation (CAM), lobar emphysema,
empyema, tracheal and bronchial malacia, pneumothorax, chylothorax,
primary and the metastatic tumors of the lung, aberrant great vessels,
vascular rings and slings, esophageal duplication cysts, esophageal
atresia and tracheoesophageal fistula (TEF), congenital and acquired
strictures of the esophagus, esophageal foreign bodies, esophageal
rupture and perforation. Techniques of laryngoscopy, bronchoscopy,
esophagoscopy, and thoracoscopy are used when required.
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Abdominal Wall
- The Pediatric Surgery service evaluates and treats a variety of
congenital abdominal wall defects including gastroschisis, omphalocele,
and Prune Belly syndrome.
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Hernias
- The Pediatric Surgery service evaluates and treats a variety of
hernias including inguinal, umbilical, epigastric and ventral.
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Gastrointestinal
- The Pediatric Surgery service evaluates and treats a wide variety
of congenital and acquired gastrointestinal disorders. Conditions
include pyloric stenosis, esophageal reflux, peptic ulcer, congenital
duodenal obstruction (duodenal atresia, stenosis, web, annular
pancreas), atresia and stenosis of small and large intestine, meconium
ileus, Meckel diverticulum, intussusception, malrotation, intestinal
obstruction from tumor or adhesions, short bowel syndrome, intestinal
duplication, inflammatory bowel disease (ulcerative colitis, Crohn
disease), mesenteric and omental cysts, ascites, polypoid diseases of
the intestinal tract, necrotizing enterocolitis (NEC), appendicitis,
Hirschsprung's disease, imperforate anus, and tumors of the abdomen and
intestine, among others. Laparoscopic techniques are used when
appropriate.
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Liver and Biliary Tract
- The Pediatric Surgery service evaluates and treats conditions of
the biliary tract including jaundice of the newborn, biliary atresia,
choledochal cyst, diseases of the gallbladder (gallstones,
cholecystitis), common bile duct obstruction, liver cysts and tumors,
liver hemangioma, portal hypertension.
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Pancreas
- The Pediatric Surgery service evaluates and treats conditions of
the pancreas including cysts, pseudocysts, pancreatitis, neoplasms,
hyperinsulinemia, islet cell adenoma.
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Spleen
- The Pediatric Surgery service evaluates and treats conditions of
the spleen including splenomegaly and hypersplenism from a variety of
hematologic disorders (sickle cell anemia, hereditary spherocytosis,
Gaucher's disease, idiopathic thrombocytopenic purpura (ITP),
thrombotic thrombocytopenic purpura (TTP), thalessemias, autoimmune
hemolytic anemias), cysts, tumors, and abscesses.
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Genitourinary
- The Pediatric Surgery service evaluates and treats undescended
testicles, testicular torsion, epididymitis, phimosis, cloacal
extrophy, cloacal anomalies, labial fusion, clitoral hypertrophy,
ambiguous genitalia, Prune Belly syndrome. The service regularly
performs circumcision procedures as well.
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Soft Tissue
- The Pediatric Surgery service treats and evaluates congenital and
acquired defects of the skin and soft tissue including cysts, nodules,
pigmented lesions/nevi, hemangioma, lymphangioma/cystic hygroma.
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Vascular
- The Pediatric Surgery service treats and evaluates congenital and
acquired vascular anomalies. These include vascular rings and slings,
and vascular injuries. The service also regularly provides vascular
access for nutrition, chemotherapy, and dialysis, as well as providing
arterial-venous fistula procedures for dialysis.
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Minimally Invasive Surgery (Laparoscopy, Thoracoscopy,
Endoscopy)
- The Pediatric Surgery regularly uses a variety of endoscopic
techniques to evaluate and treat conditions of the airway
(laryngoscopy, bronchoscopy), the chest (thoracoscopy), abdomen
(laparoscopy) and urinary tract (cystoscopy).
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