Neonatal Surgery
Neonatal surgeons at Narayana Health are experienced professionals dedicated to perform corrective surgeries on newborns. They are supported in their task by state-of-the-art equipment, modern facilities, and well trained medical staff.
The presence of a multi-specialist team at Narayana Health means that new-borns have the best care possible during the procedure and the following recovery period. The neonatal surgeons at Narayana Health treats various complex medical conditions in infants including
Foetal tumours
Foetal tumours are masses that can form from several foetal tissues. As these tumours need a significant supply of blood, they can be quite harmful to the foetus leading to heart failure and hydrops. Hydrops is a condition in which fluid accumulates in the chest, abdomen, and other tissues of the body. Most foetal tumours, however, are not malignant. Once they are removed from the body, they won’t recur.
The course of treatment for foetal tumours depends on the location, underlying presence of associated genetic conditions, and many other factors. In most cases, blocking the blood supply is the way to treat a foetal tumour, but if it is severe, neonatal surgery is essential.
Sometimes, the tumour may be present in a position that compresses the airways. For such conditions, the EXIT technique is used. EXIT or ‘ex utero intrapartum treatment’ is a special method in which an incision is made in the uterus and the baby is delivered through it. Such surgery could even be performed on the baby while in utero by experts to allow the baby to grow well for later definitive surgery once the baby is born.
Brain or spine disorders
More than 600 neurological disorders can affect individuals throughout their lifetime, and some of them can occur in newborns as well. These disorders may either exist at birth or occur shortly after birth.
Your baby’s brain development starts in the first month after conception and will continue to develop throughout pregnancy and after birth. Any disruption or injury to the brain or spinal cord during this critical period can lead to neurological problems affecting the brain, peripheral nerves, and muscles. Some of the common neonatal neurological disorders that a baby may have are seizures, encephalopathy, intracranial haemorrhage, birth asphyxia from oxygen deprivation, hypotonia, metabolic disorders of the brain, etc.
During birth, neurological disorders can be caused due to several factors, such as lack of oxygen, infections passed to the baby from the mother, physical injury leading to internal bleeding in the brain. Some of the disorders can develop during the period after birth as well due to head injury, infections like meningitis or encephalitis, immune disorders, or other medical conditions. Besides, the conditions can be inherited from one or both the parents or occur from prematurity, labour and delivery complications, genetic disorders, toxin exposure, and maternal health.
Cysts
Cysts or cystic hygromas usually occur on a baby’s head or neck as abnormal growths that can grow larger over time. It is seen that a baby develops cystic hygromas while it is still in the womb. But it can also appear after their birth.
The treatment for cystic hygromas does not begin while the baby is in the womb. Instead, the doctor will monitor the health of the baby to decide the required course of treatment. If they occur early in pregnancy, they might go away before birth. But if they are still present, neonatal surgery or new-born surgery is the first step of treatment. The cyst is entirely removed by surgical procedures so that it doesn’t recur. The cysts are not malignant, so the doctor may not consider surgery if it’s not causing any damage to the healthy tissues.
If cystic hygromas have grown large, techniques like sclerotherapy, chemotherapy, radiation therapy, and steroid medication may be used. These treatments shrink the size of the cyst so that they can be removed easily.
Hernia
A hernia is a condition that occurs when a part of the bowel or intestine pushes through a weak wall of muscle holding the intestine in place inside the belly. A hernia can occur in any baby, but it is more likely to be seen in:
- Premature babies, as they may have an underdeveloped abdominal muscle
- Babies with lung disease or a condition where they strain to breathe
- Boys, as it is easy for a hernia to develop in the space where the testicles descend
A hernia can be two types, i.e. inguinal hernia and umbilical hernia. An inguinal hernia is a condition in which a section of the bowel extends into the groin area or the scrotum, in the case of boys. On the other hand, umbilical hernias develop in a weak area or muscle around the navel.
A hernia isn’t dangerous unless it is stuck in a weak spot or gets strangled. This could cut off blood flow to the strangulated part of the bowel and the section of the bowel can burst or die. In boys, low blood flow to the testicle can lead to partial or complete damage to the organ. Surgery is necessary as soon as a hernia is detected to prevent the possibility of strangulation.
Lung Lesions
Foetal lung lesions or lunge masses develop in the lungs before the birth of the baby. The two most common types of lung lesions are Congenital Pulmonary Adenomatoid Malformation (CPAM) and Bronchopulmonary Sequestration (BPS).
In CPAM, there is an abnormal development in a part of the lung which turns into a mass of lung tissue. As this tissue isn’t connected to the airway, the fluid within the mass can’t get out. In BPS, there’s an abnormally functioning extra piece of lung tissue with a separate blood supply that causes several problems. Other types of lung masses include Pulmonary Blastoma and Congenital Lobar Emphysema.
Although most of the lung masses or lesions are non-cancerous, these problems can turn severe. So, they need to be treated before or immediately at birth. However, lung lesions are usually managed months after birth in an elective setting. If neonatal surgery is performed, your baby has to stay in the NICU (Neonatal Intensive Care Unit). Once they are discharged after the removal of the lung lesion, they can grow into healthy children and adults.
What We Do at Narayana Health
At Narayana Health, we ensure that our patients get appropriate access to our advanced and multidisciplinary care after undergoing any neonatal surgery. Our team has expertise in foetal, maternal, and paediatric specialities as well so that you receive the best comprehensive treatment plan to help you and your baby get the best start in life.
Neonatal Surgery FAQs
Can newborns have surgery?
Critically ill or premature newborns may need surgery soon after birth to address abnormalities or defects. Newborn surgery requires a highly specialized level of care. A pediatric surgeon works closely with the perinatologists, neonatologists, pediatric anesthesiologists to perform exceptional Neonatal surgery for newborns.
What is the most common pediatric surgery?
A Neonatal Surgeon treats Congenital health problems that occur during the development of the baby and Acquired health problems that occur in children after they are born. Some of the common surgeries for infants are -
- Appendicitis - Infected or inflamed appendix.
- Pyloric stenosis - A condition where the opening between the stomach and small intestine is narrowed. With the help of neonatal surgery, the opening is enlarged.
- Biliary atresia - In this condition, the bile ducts outside and inside the liver are scarred and blocked. The bile builds up in the liver and damages it, as the bile can not flow into the intestine.
- Hirschsprung’s disease - A condition of the large intestines that causes difficult bowel movements.
- Reproductive disorders - Medical conditions that affect a child’s reproductive organs.
- Cancer - Newborn surgery helps in conditions like Hepatoblastoma (liver cancer), Neuroblastoma (cancer near the kidney area), Wilms tumour (cancer found in the kidney), Portocath. Portocath is a procedure used mostly during chemotherapy.
- Short bowel syndrome - Part of the small intestine is missing or it is not working properly, which leads to failure in absorbing sufficient nutrients.
- Congenital cystic adenomatoid malformation (CCAM) - It is a benign lung lesion that appears before birth as a cyst or mass in the chest.
- Imperforate anus (anal atresia) - It refers to a spectrum of anorectal abnormalities ranging from a membranous separation to complete absence of the anus.
- Congenital diaphragmatic hernia - A hole in the diaphragm that creates a condition where the abdominal organs migrate into the chest.
- Esophageal Atresia (EA) and Tracheoesophageal Fistula (TEF) - EA and TEF are two disorders of the digestive system. EA is when the esophagus doesn’t connect to the stomach. TEF is a condition where the esophagus and windpipe (trachea) don’t connect correctly.
- Necrotizing enterocolitis - It is a devastating disease that affects mostly the intestine of premature infants, where the wall of the intestine is invaded by bacteria and causes local infection and inflammation that can ultimately destroy the wall of the bowel (intestine).
- Pectus carinatum - A congenital condition where theres an abnormal amount of growth between a child’s breast bone and ribs.
- Gallbladder problems - Conditions such as Gallstones, Common bile duct stones, Gallbladder cancer, Inflamed gallbladder, Perforated gallbladder, Bile duct infection, Dysfunctional gallbladder or chronic gallbladder disease are treated.
Do neonatal doctors perform surgery?
A Pediatrician can solve almost all kind of health problems of newborns, but a Neonatologist is specifically trained to handle complex and high-risk situations in newborns. A Neonatologist performs surgery with a team of Pediatric Doctors, Surgeons and Nurses.
What Types of Treatments Do Neonatologists Provide?
- They diagnose and treat newborns with conditions such as birth defects, infections, and breathing disorders.
- A Neonatologist medically manages premature newborns or who are critically ill, or in need of surgery.
- They ensure that premature newborns receive proper nutrition for growth and healing.
- They provide care to the newborn at a cesarean delivery that involves the mother or the baby having medical problems. Such situations are risky for an infant’s health and require medical intervention in the delivery room.
- They stabilize and treat newborns with any life-threatening medical problems.
- They consult with paediatricians, obstetricians, and general physician about conditions affecting newborn infants.
Can babies die from anaesthesia?
Anaesthesia is not fatal. Nowadays, Anesthesia is very safe. In very rare and delicate cases, it causes complications in children, like breathing problems, allergy or reaction to a medicine, strange heart rhythms etc. The doctor will evaluate the current health condition of the baby and then recommend if anaesthesia is safe for the child given the circumstances after weighing the risks.
