Why choose paediatric surgery?

[Kei22]

I ask because I read this
"Only 11% of operations on children are carried out by paediatric surgeons. The remainder are performed by other specialist surgeons, some of whom specialise in paediatric cases. These include general, orthopaedic, plastic, oral and ophthalmic surgery as well as ENT and urology. Specialist adult surgeons may work in partnership with paediatric surgeons to treat uncommon childhood disorders such as thyroid and certain gastrointestinal conditions."
Are there any procedures paediatric surgeons do exclusively

---

Members don't see this ad.

 

[Southplains]

Are there any procedures paediatric surgeons do exclusively

Yes there is quite a large number of procedures only they do. You have to realize a great number of surgeries in children are going to be things like tubes in the ears, undescended testis, tonsils, appendix, gall bladder, spina bifida, scoliosis, fracture repairs etc. These are not done be peds surgeons but the respective sub specialties +/- their own peds fellowship, or just a general surgeon.

Peds surgery proper usually only had a couple of attendings and they stay super busy/ lots of call. Hernias (inguinal, diaphragmatic), the concave chest thing, teratomas/other malignancies, imperforate anus, hirschprungs, etc. I don’t know all of them, but I know they stay super busy, super competitive fellowship, and the residencts who match peds are, I believe, typically seen as very strong residents.

 

[startswithb]

And so, so many appys.

 

[Smurfette]

Don't forget all the NEC babies. Seems like those were a huge number of those patients on that service but only some got operated on. And broviac central line placements. And circs on former premies who were too delicate to have them done earlier in life (may not be ubiquitous but we had a LOT of these referrals during residency).

I can tell you that in residency, our peds surgeons did peds urology stuff as well (there was no dedicated peds urologist at our center) and PDA ligations (peds CT surgery just did heart surgeries).

Classically peds surg does a lot of the congenital abnormalities--stuff missed above include pyloric stenosis, TE fistulas, pectus excavatum ("the concave chest thing"), gastroschisis/omphalocele, etc. As kids get older, many of the common surgical problems begin to mirror that of adults (appys, hernias, etc.) so it's not unusual for older kids to see a local surgeon rather than go to a big peds surgery center for a common problem. There are places where general surgeons do pyloric stenosis cases as well, although fewer and fewer places are comfortable anesthetizing month old babies.

 

[ragha1234]

pediatric surgeons do neck, thorax, foregut, midgut, hindgut / colorectal. In some places liver.
cardiothoracic and urology are separate
11% of ops on children by peds surgeons is a gross underestimation

 

[Winged Scapula]

pediatric surgeons do neck, thorax, foregut, midgut, hindgut / colorectal. In some places liver.
cardiothoracic and urology are separate
11% of ops on children by peds surgeons is a gross underestimation

Are you sure?

Remember, "all operations" would include tonsillectomy and myringotomy by ENT, appys by general surgeons, ORIFs by orthopedic surgeons, etc. Those likely account for the vast majority of pediatric surgeries.

 

[ragha1234]

ENT and ortho are different, they are not touched by anyone who does general surgery specialties, so I was not thinking of them

appys is a good point, most pediatric surgeons do pediatric appys IF a pediatric service is available. However, adult surgeons may end up doing pediatric appys as pediatric surgery tends to be concentrated in academic centers

 

[NITRAS]

My friend who just got started does a wide range of surgeries, which I would normally consider to be done by a range of specialists in adults.

 

[deleted547339]

So you can write “paediatric”?

 

[Winged Scapula]

ENT and ortho are different, they are not touched by anyone who does general surgery specialties, so I was not thinking of them

appys is a good point, most pediatric surgeons do pediatric appys IF a pediatric service is available. However, adult surgeons may end up doing pediatric appys as pediatric surgery tends to be concentrated in academic centers

Which is sort of my point; the vast majority of care in the US is NOT in academic centers, so the majority of pediatric surgery would be done by general surgeons, IMHO

 

[ragha1234]

Which is sort of my point; the vast majority of care in the US is NOT in academic centers, so the majority of pediatric surgery would be done by general surgeons, IMHO

You mean majority of the pediatric appys. Could be true, but I have no proof one way or another. Pediatric surgery otherwise is a complex field that requires specialised training. Don’t think can be handled by adult surgeons unless highly experienced.

 

[Winged Scapula]

You mean majority of the pediatric appys. Could be true, but I have no proof one way or another. Pediatric surgery otherwise is a complex field that requires specialised training. Don’t think can be handled by adult surgeons unless highly experienced.

I am well aware of the pediatric surgery can be very complex.

However if you’re arguing that the majority of pediatric surgery done are things like PSARPs or Kansai procedures, you’re wrong.

The majority of operations on children are minor things like appendectomies or hernia repairs ( with the obvious exception of the ENT procedures which you decided to eliminate above ). The majority of these operations and all pediatric operations are done by general surgeons in the community.

Obviously when you’re talking about complex surgeries those are usually done at academic medical centers. But that’s not what you talked about in the first place when you claimed differently.

I’m not sure if you’re arguing with me because I deleted your spam in this forum but it’s not necessary; we both agree that pediatric surgery can be very complex but out of all the operations performed on children most aren’t done by fellowship trained pediatric surgeons

 

[LucidSplash]

Peds surg is an inverse bell curve. The left side of the bell curve is all the appys and gallbags on fat kids, along with the circs/inguinal hernias/umbo hernia repairs/lump and bump removals. Most of those are done in the community, frequently by gen surg. The other end of the curve is a different story. Don’t conflate the two.

 

[vselin]

Hey ! Is there any resident in peds surgeon , I am a second year resident in peds surgery, i love my job .I am from a different country , not USA. In our clinic we almost operate all kind of cases about pediatric surgery, i just wanna to meet others to share our experiences. At the same time , our hospital is a trauma center in pediatrics and we have a burn care unit,too, so i saw various patients , what about you?