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SurgSpace / Specialties / Pediatric Surgery

Pediatric Surgery

Surgery of children and neonates, where the diseases are congenital as often as acquired, the anatomy still moving, and the doses, tubes and consent all scale with age. Bilious vomiting in a baby is this specialty's 'chest pain': an emergency until proven otherwise.

3 operations in depth5 interactive cases

Backdrop: Abdominal ultrasound in a child showing the target sign of an intussusception · Cerevisae · CC BY-SA 4.0

Inside the OR

OR & Periop

Shared operative foundations, the room, the instruments, the anaesthetic.

Shared operative foundations taught once, the room they happen in, the instruments on the tray, and the anaesthetic that makes it possible.

  • Children are not small adults

    The specialty's operating system: physiology, pharmacology, fluids and consent all scale with age, and the scaling changes decisions rather than just doses. Taught once here; every paediatric operation and emergency assumes it.

    1. 01Compensation's cliff. Children maintain blood pressure by rate and constriction until very late: a normal BP in an unwell child is not reassurance, and tachycardia plus quietness is a pre-arrest picture, not a grumpy patient.
    2. 02Weight-based everything. Drugs, fluids, blood, tube sizes and defibrillation all run per kilogram: estimate or measure the weight early, and use the resuscitation aids rather than arithmetic under stress.
    3. 03Fluids and sugar. Boluses are measured (10-20 mL/kg) and reassessed; maintenance follows weight-banded rules; and small children run out of glucose fast, so the sick child's gas includes it.
    4. 04The family is the patient's context. Consent involves parents and, increasingly, the child; examination is opportunistic and gentle; and the observation 'parent says something is wrong' has genuine diagnostic weight.
    5. 05Different diseases entirely. Age is a differential-sorting machine: bilious vomiting, groin lumps and limps mean different diseases at different ages, and the congenital list sits behind every presentation in the first months.
    Used byRamstedt pyloromyotomyLadd's procedure for malrotationPaediatric inguinal herniotomy

On the tray

No instruments are tagged to this specialty’s operations yet.

Anaesthesia

The airway, the depth, the haemodynamics and the analgesia: the head of the bed has its own rooms.

Enter anaesthesia

Watch and learn

When an operation is best understood in motion

  • Open pyloromyotomy through a transverse incision

    The paediatric surgery education channel's operative footage of the Ramstedt myotomy.

    Watch for

    • Delivering the pylorus
    • Splitting the muscle down to bulging mucosa
    • The test for a mucosal breach
    Source: StayCurrentMD · Watch on YouTube

  • Laparoscopic Ladd's procedure

    Dividing the bands, widening the mesentery, the appendix, and the bowel laid in non-rotation.

    Watch for

    • Ladd's bands crossing the duodenum
    • Broadening the mesenteric base
    • Why the appendix comes out
    Source: SAGES · Watch on YouTube

  • Inguinal hernia repair: operative aspects in children

    The herniotomy: sac, cord structures, high ligation, nothing else.

    Watch for

    • Separating the sac from the vas and vessels
    • High ligation at the deep ring
    • No mesh, no floor repair
    Source: Pediatric Surgery Operative · Watch on YouTube

  • Pediatric inguinal hernia in brief: presentation, workup and perioperative considerations

    The decisions around the operation: timing, the contralateral side, and the ex-premature infant.

    Source: StayCurrentMD · Watch on YouTube

Watch for

Ramstedt pyloromyotomy

  • Fluid and electrolyte correction first
  • Access
  • The myotomy
  • Leak check and early feeding
Find candidates on YouTube

Watch for

Ladd's procedure for malrotation

  • Entry and assessment
  • Detorsion
  • Dividing Ladd's bands and widening the mesentery
  • Appendicectomy and final placement
Find candidates on YouTube

Watch for

Paediatric inguinal herniotomy

  • Groin crease incision
  • Isolating the sac
  • High ligation
  • Testis check and closure
Find candidates on YouTube

Embedded videos are curated and attributed. The search doors are labeled searches for reviewers to source candidates from, not endorsements; nothing plays here until it has been reviewed.

Hub shaped by the Surgical Specialties Lead with the Paediatric surgery reviewer (open seat). Images and videos carry their source; educational use for supervised learning, not clinical guidance.