What Are the Most Common Paediatric Surgeries?

Paediatric surgery involves specialized procedures performed on children to treat a wide range of medical conditions, from congenital abnormalities to acquired diseases. Unlike adult surgeries, paediatric surgeries require a unique approach, as children’s bodies are still growing and developing, and they often require delicate care and expertise. The field of paediatric surgery encompasses several specialties, including general surgery, urology, orthopaedics, and cardiovascular surgery.

In Kenya, access to skilled paediatricians in Kenya who can diagnose and recommend the appropriate surgical interventions has significantly improved. This article explores some of the most common paediatric surgeries, their purposes, and how they contribute to improving children's health.

1. Appendectomy

One of the most frequently performed paediatric surgeries, an appendectomy, is the removal of the appendix due to appendicitis. Appendicitis occurs when the appendix becomes inflamed, often due to an obstruction. Symptoms include severe abdominal pain, fever, and vomiting, and if left untreated, it can lead to a ruptured appendix, which is life-threatening.

Surgeons typically perform this procedure laparoscopically, minimizing recovery time and reducing scarring. Paediatricians in Kenya recommend prompt diagnosis and surgical intervention for appendicitis to prevent complications.

2. Tonsillectomy and Adenoidectomy

Tonsillectomy (removal of the tonsils) and adenoidectomy (removal of the adenoids) are common surgeries performed to treat chronic infections or breathing problems caused by enlarged tonsils and adenoids. These issues can lead to obstructive sleep apnea, recurrent throat infections, or difficulty swallowing.

This outpatient procedure is often recommended for children who experience frequent infections or difficulty breathing. Recovery usually involves mild discomfort and a soft-food diet, with children resuming normal activities within a week.

3. Hernia Repair

Hernias, which occur when an organ or tissue pushes through a weak spot in the abdominal wall, are common in children, particularly inguinal hernias. These hernias may be present at birth or develop shortly after and are more prevalent in boys.

Surgery is necessary to prevent complications such as incarceration or strangulation of the hernia. Hernia repair is a relatively straightforward procedure where the protruding tissue is pushed back into place, and the abdominal wall is strengthened.

4. Circumcision

Circumcision is one of the oldest and most commonly performed paediatric surgeries worldwide, including in Kenya. The procedure involves the removal of the foreskin from the penis and is often performed for cultural, religious, or medical reasons.

Medically, circumcision may be recommended to prevent or treat conditions like phimosis (tight foreskin), recurrent infections, or hygiene issues. It is typically a quick outpatient procedure with a short recovery time.

5. Congenital Heart Defect Repair

Congenital heart defects, such as atrial septal defects (holes in the heart) or ventricular septal defects, often require surgical correction in infancy or early childhood. These surgeries aim to improve heart function and prevent complications such as heart failure or developmental delays.

Paediatric cardiac surgeons use advanced techniques to repair these defects, often through minimally invasive methods or open-heart surgery. Timely intervention by skilled paediatricians in Kenya can significantly improve a child’s quality of life.

6. Cleft Lip and Palate Repair

Cleft lip and palate are congenital abnormalities that occur when the tissues of the upper lip and roof of the mouth do not fuse properly during pregnancy. This condition affects a child’s ability to eat, speak, and breathe properly.

Surgical correction involves multiple stages, with initial repair typically performed within the first year of life. Early intervention ensures better functional and cosmetic outcomes, enabling children to lead healthier lives.

7. Intestinal Obstruction Surgery

Intestinal obstruction, often caused by conditions like intussusception or congenital malformations, can lead to severe abdominal pain, vomiting, and inability to pass stool. This is a medical emergency that requires prompt surgical intervention to remove the blockage and restore normal bowel function.

Surgeons carefully remove the obstruction and may repair any affected areas of the intestine. Early diagnosis by paediatricians in Kenya is crucial to prevent complications such as bowel necrosis.

8. Hypospadias Repair

Hypospadias is a congenital condition where the urethral opening is located on the underside of the penis instead of at the tip. This condition can affect urination and, later in life, sexual function.

Surgical correction is typically performed before the age of two to reposition the urethral opening and improve functionality. The procedure has a high success rate and helps prevent future complications.

9. Orthopaedic Surgeries

Orthopaedic surgeries in children often address congenital or acquired musculoskeletal conditions, such as clubfoot, scoliosis, or fractures. These surgeries aim to correct deformities, improve mobility, and prevent long-term complications.

For example:

• Clubfoot Correction: A series of casts or surgical procedures are used to align the foot properly.

• Fracture Repair: Severe fractures may require surgical intervention to ensure proper healing and bone alignment.

10. Removal of Tumors

Tumor removal surgeries are necessary for conditions such as Wilms’ tumor (a kidney cancer) or neuroblastoma. These procedures are often part of a broader treatment plan that may include chemotherapy or radiation therapy.

Advances in paediatric oncology have made these surgeries safer and more effective, with many children achieving full recovery. Access to specialized paediatric surgeons and oncologists in Kenya has improved outcomes for children facing such conditions.

11. Appendix-Related Abscess Drainage

In cases where appendicitis has progressed to an abscess, surgical drainage may be required before or instead of an appendectomy. This procedure involves removing infected fluid to alleviate symptoms and prevent further complications.

Conclusion

Paediatric surgery plays a vital role in addressing health conditions that affect children, often improving their quality of life and overall health outcomes. From routine procedures like circumcision and hernia repair to complex surgeries for congenital heart defects or cleft palate repair, these interventions are tailored to the unique needs of young patients. Skilled paediatricians in Kenya ensure timely diagnosis and appropriate surgical referrals, enabling better outcomes for children.

For parents, understanding these procedures and preparing for them with the guidance of experienced healthcare providers is crucial. With advancements in medical technology and expertise in paediatric care, children undergoing surgery today have access to safer and more effective treatments than ever before.