The Department of Paediatric Surgery's mission is to provide and promote excellence in the surgical care for children.
We manage surgical problems in newborns, infants, toddlers, children and teenagers, up to the age of 16 years. Our surgical spectrum includes:
- Congenital abnormalities in various body systems due to abnormal development in the foetus during pregnancy. These abnormalities are commonly picked up by the obstetrician during pregnancy scans.
- Lumps and bumps on various parts of the body and problems with the genitalia and groin in both sexes such as phimosis, undescended testes and scrotal swellings like hernia and hydrocele. These are commonly picked up by the GP.
- Surgical problems with intestines, liver, kidneys and other major body systems (except the heart and the brain, which are done by the NUH's Heart service and University Surgical Cluster respectively)
Specialised Paediatric Surgical Services
Children with urological problems need to be managed by paediatric experts who routinely see and treat these problems.
- A complex and poorly understood area is that of intersex. Disorders of sexual differentiation result in ambiguous sexual appearances. Management issues centre around the identification of the correct gender, confirmation whether this is congruous with the internal organs, potential for future fertility and offering appropriate counseling and informed decisions on surgical procedures.
- Urodynamics - Children with wetting and neurologically affected bladders need specialised diagnostication and individualised care. Our team offers evaluation of bladder dynamics with the latest equipment in a child-friendly
environment. Depending on our test results we can then
offer bladder surgery to these patients.
We offer counselling in conjunction with the obstetricians to parents of unborn children with abnormal pregnancy scans. Parents are able to ask questions, allay their anxiety and make informed decisions.
Laparoscopy (Keyhole Surgery)
With the current emphasis on a minimally invasive millennium, there has been a changing trend with laparoscopy getting increasing importance. This helps the children experience less pain, go home earlier and recover faster.
Currently, the department offers minimally invasive surgery related to the lungs, appendix, stomach, kidneys, internal reproductive organs, developmental malformations of the rectum and anus (namely gastrooesophageal reflux, anorectal malformations, intersex disorder, nonfunctioning kidneys, undescended testis, appendicitis, varicoceles and thoracic lesions).
This is an ever expanding field. With the emergence of supporting evidence from international literature, more and more operations will be offered under this category.
Day Case Surgery
This has revolutionised the surgical care of children in need of minor operations. They are admitted, operated and discharged all in one day without any adverse effect on the outcome. Clearly there is less trauma of hospitalisation and better utilisation of resources with earlier appointments for operations. The logistics can be discussed during the clinic visit with the surgeon.
Our paediatric oncology team consists of dedicated oncologists, surgeons and nursing staff. Patients get treated in a separate oncology ward with isolation rooms if necessary.
The surgeon's role is to provide a biopsy, insert central lines for chemotherapy and resect the tumours as feasible.
The tumours commonly operated on are Wilms tumour, Neuroblastoma and Hepatoblastoma.
Paediatric organ (liver and kidney) transplantation has developed as a specialised treatment for children suffering from irreversible organ failure.
Prof K. Prabhakaran is the Chief of the National Liver transplant programme including paediatrics. Dr. Dale Loh is an active surgical member of the transplant team.
Paediatric kidney transplants are also performed by the same team of consultants.
We have a regular referral base from the neighbouring countries for second opinion on complex paediatric surgical problems and re-operations for surgical complications in children.
The Department of Paediatric Surgery sees the following diseases and conditions:
- Congenital Cystic Adenomatoid Malformation (CCAM)
- Congenital Lobar Emphysema (CLE)
- Lung sequestration
- Oesophageal Atresia and Tracheo-oesophageal Fistula
- Congenital Diaphragmatic Hernia
- Eventration of Diaphragm
- Duplication of the gut
- Pyloric Stenosis
- Duodenal Atresia / Stenosis
- Intestinal Atresias
- Meconium Ileus
- Necrotizing Enterocolitis
- Biliary Atresia
- Choledochal cyst
- Anorectal Malformations
- Hirschsprung’s disease
- Posterior Urethral Valves
- Prune Belly Syndrome
- Cloacal Exstrophy
- Ambiguous Genitalia and Intersex conditions
- Sacrococcygeal Teratoma
- Pelvi-ureteric Junction Obstruction
- Duplex Kidneys
- Vesico-ureteric Reflux
- Vesico-ureteric Junction Obstruction
- Posterior urethral valves
- Neurogenic Bladder
- Undescended Testes
- Surgery for End Stage Renal Disease
- Wilm’s Tumour (Nephroblastoma)
- Cystic Hygroma
- Branchial cyst / Branchial cleft abnormalities
- Thyroid / Parathyriod Lesions
- Breast Swellings
- Pectus Excavatum
- Gastro-oesophageal Reflux
- Umbilical / Supraumbilical hernias
- Inguinal / Femoral hernias
- Acute Scrotum
- Inflammatry Bowel Disease
- Gastrointestinal Polyps
- Anorectal prolapse, Abscess, Fissure
- Vascular malformations
- Transplantation for End-stage Liver Disease