Laura Granfortuna, Author at Austin Pediatric Surgery

Understanding Pediatric Inguinal Hernia Repair Surgery

Posted on May 7, 2023 | by Laura Granfortuna

Your top priority as a parent is keeping your child safe and free from pain or sickness. So what happens when they develop a condition that puts that at risk? You find the top children’s hospital in Austin to ensure they get the treatment they need to feel healthy again.

If you notice your child has developed a bulge or swelling in their lower belly near their groin area, this points to a condition known as an inguinal hernia.

What is a Pediatric Inguinal Hernia?

A pediatric inguinal hernia is a condition in which swelling of the groin area results from a hole that lets contents in the abdomen move into the groin. Inguinal hernias may allow intestines or other organs to pass through.

These types of hernias are not caused by your child lifting something too heavy or straining. Instead, the defect is present at birth, and the straining leads to internal organs moving through the hole into the groin.

Inguinal hernias do not heal on their own and require surgical intervention.

Inguinal Hernias in Girls vs. Boys

Inguinal hernias can affect both infant girls and infant boys, but it is more common in boys.

While in the womb, your child develops a short tunnel through the abdominal wall. This tunnel should seal off naturally before they’re born; if not, an inguinal hernia can form. The only difference between girls and boys with this condition is where the abdominal cavity connects.

Inguinal Hernias in Infant Girls

With inguinal hernias in infant girls, the short tunnel connects the abdominal cavity to their labia. If the passage does not close, a pouch – an inguinal hernia – can form within the belly lining.

Inguinal Hernias in Infant Boys

With inguinal hernias in infant boys, the short tunnel connects the abdominal cavity to the scrotum. This tunnel is how their testicles – which grow inside the abdomen before birth – move into the scrotum.

How is an Inguinal Hernia Diagnosed?

Infant inguinal hernias are typically spotted during a routine exam by your child’s pediatrician. A bulge near their groin will be apparent, making it easy to diagnose. If additional testing is needed to confirm, an ultrasound may be performed.

Since nearly all cases of this condition are present at birth and are most common among infant boys, your child’s provider should take extra care to spot an inguinal hernia before it becomes an emergency.

What is the Treatment for Inguinal Hernia?

The treatment for your child’s inguinal hernia is pediatric inguinal hernia repair surgery. Rarely do inguinal hernias cause pain unless the intestines have moved through the open passageway and gotten stuck. If this happens, your child’s bulge will appear firm and red. This will require that your infant undergo an emergency hernia repair surgery.

Why Does Your Child Need Surgical Intervention for an Inguinal Hernia?

Inguinal hernias do not heal on their own. Treatment is necessary because incarceration or strangulation of the hernia is possible and can be extremely painful and dangerous.

“These types of hernias are not typically caused by your child lifting something too heavy or straining. Rather, the defect is present at birth, and the straining leads to internal organs moving through the hole into the groin.”

What is the Inguinal Hernia Procedure?

The surgery to fix an inguinal hernia is a straightforward outpatient procedure that takes less than an hour:

Your child’s pediatrician makes a tiny incision in the groin
Any intestines that have shifted down are moved back into the abdomen, and the hernia sac is closed off.
A camera may be inserted to see if a hernia is present on the other side.
The hole is closed with dissolvable sutures, and the wound is covered with Steri-Strips or DERMABOND.

Recovery from infant hernia surgery is quick. Your child can leave the hospital a few hours after the procedure and resume normal activities usually within 2 weeks.

Why Choose Austin Pediatric Surgery for Your Child’s Inguinal Hernia Repair

At Austin Pediatric Surgery, we are highly experienced in the classic open repair as well as laparoscopic inguinal hernia repair and perform scheduled and emergency surgeries.

At our pediatric surgery center, we perform this procedure using a minimal incision and without using mesh or screens whenever possible. During the procedure, a tiny camera may be used to check for any secondary hernias. When the procedure is finished, dissolvable sutures are placed.

Infant Hernia Surgery: Don’t Wait

Because surgery is necessary for your child’s inguinal hernia, you want to choose a pediatric surgeon in Austin you can trust. Call and speak with a member of our team today for more information.

Source: Pexels

What You Need to Know About Infant Testicle Surgery

Posted on April 30, 2023 | by Laura Granfortuna

While your newborn having an undescended testicle might come as a shock, it is not a huge cause for concern. This occurs in about 4% of infant males when, while growing inside the womb, the testicles develop inside of his abdomen and fail to move down into his scrotum.[1]

The solution is a simple one: surgery. Treatment for a undescended testicle is an orchiopexy procedure that requires either a laparoscopy or open surgery with general anesthesia. This type of procedure has a 95% success rate.[2]

Why Would My Child Infant Need Testicle Surgery?

Undescended testicles are a result of an infant male’s testicles, after developing in his abdomen, failing to drop into his scrotum while he is growing inside his mother’s womb. Your doctor can diagnose undescended testicles by examining the child.

While undescended testicles aren’t inherently harmful, the complications from them can be. Infertility and testicular cancer are the main issues that males with undescended testicles can face later in life if an orchiopexy isn’t performed within 18 months after birth.

However, it’s recommended that you see a specialist or pediatric surgeon if your son’s testicle hasn’t descended or can’t be located within 6 months after birth.

If it’s determined that there are no testicles at all versus undescended testicles, diagnosis immediately after birth can help prevent conditions that result from absent testicles. That’s why seeking out a surgeon you can trust early on can lower the risk of complications and give you peace of mind.

What is the Process for Infant Testicle Surgery for a Child?

Orchiopexy may require more than one surgery to repair. These surgeries are outpatient procedures, which means you can take your son home after surgery. But what happens during the procedures?

Your son will undergo anesthesia so the surgery can be performed.
Once your infant is asleep, their surgeon makes a small cut in his groin or may place a camera in the abdomen to find the testicle.
The surgeon examines the undescended testicle to ensure it’s healthy.
If necessary, a hernia sac repair might need to be done first.
After any hernia is repaired, a second cut in the scrotum is made to create a pocket for the testicle to sit in.
With a surgical tool, the surgeon pulls the undescended testicle down into the pocket they created.
To finish, the surgeon secures the two cuts made with dissolvable stitches that dissolve after a week or two.

You and your son can go home about two hours after they undergo an orchiopexy procedure.

Pediatric Testicle Surgery: Questions to Ask the Surgeon

When it comes to your child, there are no questions you can’t ask. Let’s go over a few of the most common so you feel confident scheduling testicle surgery for your son.

How long do I withhold food for my son after surgery?

The reason it’s recommended to limit food post-op is due to the effects of the anesthesia used during the surgery. Start with clear liquids, and consider avoiding rich foods for the day after surgery to avoid nausea.

What is the recovery time after an orchiopexy?

Give your son 2-3 days after the procedure before he resumes daily activities. A few specific activities to avoid are jumping, running, and straddling toys like tricycles or rocking horses.

How do I control my son’s post-op pain?

Since an orchiopexy isn’t a major surgery, your son’s discomfort can be managed with over the counter medicine like aspirin, acetaminophen, and ibuprofen. Applying ice four times a day for at least 10 minutes can not only control pain, but limit swelling of his groin.

When do I need to call the doctor if I think something’s wrong?

There are 5 symptoms that make it clear it’s time to call your doctor after your son undergoes testicle surgery:

Heavy bleeding
A high fever
Severe pain
Severe swelling
Infection

What signs of infection do I need to look out for?

An infection can indicate there is something wrong with the affected area. Signs to watch out for include pus or redness along the incision sites, a 101 degree or higher fever, and increased pain or swelling.

Does Your Child Need Testicle Surgery?

It’s recommended that you find a surgeon you can trust before treatment is needed. That’s because surgery for undescended testicles is best done immediately to prevent future complications.

If you’re looking for a pediatric surgeon who has experience with testicle surgery, Austin Pediatric Surgery has the best surgeons for the job.

Sources:

[1]: https://www.chp.edu/our-services/surgery-pediatric/patient-procedures/undescended-testicle-orchiopexy-repair-surgery

[2]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4889701/

[3]: https://my.clevelandclinic.org/health/treatments/17297-orchiopexy

[4]: https://www.chop.edu/treatments/surgery-undescended-testicles-orchiopexy

Photo source: Pexels.com

My Child Has an Umbilical Hernia. How Worried Should I Be?

Posted on April 25, 2023 | by Laura Granfortuna

What is an Umbilical Hernia?

An umbilical hernia presents as a bulge or protrusion in your infant’s belly button. It is commonly found during the routine doctor’s visits they go to for the first few months of life. While this condition is visually alarming, it isn’t usually cause for concern.

When the umbilical cord is cut, the ring typically closes on its own due to rectus muscle growth and fascial layer fusion. But when the fascia of the ring doesn’t close properly, intraabdominal contents may protrude. This results in a bulge in your child’s belly button.

When your child cries, coughs, or strains to have a bowel movement, umbilical hernias may become more noticeable. However, when your child is quiet and resting, the bulge may diminish. Umbilical hernias do not usually cause pain, which should provide you some relief.

How Common is an Umbilical Hernia?

Umbilical hernias affect boys and girls equally. However, umbilical hernias are most common in premature babies and African-American infants. If your child falls into one (or both) of those categories, it is important to tell your pediatrician about any signs a hernia has developed.

The good news is that 90% of umbilical hernias close on their own by the time a child is 4 to 5 years old. Often, doctors suggest delaying treatment due to a low rate of complications while waiting for the defect to close on its own. The size of the hernial ring is helpful to determine if it will close on its own.

“Umbilical hernias are most common in premature babies and African-American infants. If your child falls into one (or both) of those categories, it is something to keep an eye on and tell their doctor about.”

When Does an Umbilical Hernia Need Treatment?

Although pediatric umbilical hernias are common among healthy infants, they are also associated with specific conditions such as common autosomal trisomies, metabolic disorders, and dysmorphic syndromes. It’s important that your doctor distinguishes whether your baby’s condition warrants further evaluation.

If your infant’s umbilical hernia does not close on its own in their first few years of life, there are signs that will tell you it’s time to seek treatment:

The bulge is firm, painful, or discolored or the hernia sticks out and can’t be pushed back into your infant’s abdomen.

– these signs suggests the hernia is stuck and may be an emergency

Your baby is over 4-5 years old and the hernia is still present.

What is the Treatment for an Umbilical Hernia?

The treatment for an umbilical hernia is umbilical hernia surgery. Due to how common pediatric umbilical hernias are, surgery is done in a single day. That means you can bring your child home the same day as the procedure. The procedure is performed while your baby is under general anesthesia.

What Happens During Umbilical Hernia Surgery?

The surgery for umbilical hernia is relatively straightforward. First, a small curved incision (resembling a smile) is made under your child’s belly button. Then the opening is closed with absorbable sutures and the overlying skin is closed with a combination of absorbable stitches below the skin and DERMABOND.

Umbilical Surgery Aftercare

Hernia surgery recovery is simple. Immediately after surgery, your child’s belly button may be slightly swollen, but you can expect this to go away in a few weeks. Refrain from allowing your baby to participate in physical activity for 2-3 weeks post-surgery. Their follow-up appointment should be scheduled for 2-4 weeks after the procedure, when their doctor will evaluate your child’s recovery.

There is a very small risk of recurrence of umbilical hernia once surgery is performed. If you notice that your child’s hernia has reappeared, call your Austin Pediatric Surgeon.

Umbilical Hernia Treatment at Austin Pediatric Surgery

Pediatric umbilical hernias are very common, and a routine surgery will fix the problem. If your child is showing signs of an umbilical hernia, contact Austin Pediatric Surgery to discuss treatment.

Image credit: Nataliya Vaitkevich via Pexels.

Inflammatory Bowel Disease: Everything You Need to Know About Your Child’s Surgery

Posted on April 25, 2023 | by Laura Granfortuna

Inflammatory bowel disease (IBD) is an inflammation of the intestine that is immune-mediated. It’s not known exactly what causes this disease, but most medical researchers believe it’s a combination of genetics, the presence of bacteria, and possible environmental causes.

What Types of Inflammatory Bowel Disease May Require Pediatric Surgery?

IBD can be categorized into three specific diagnoses, all of which may present different symptoms and require different treatment measures: Crohn’s disease (CD), ulcerative colitis (UC), and IBD unspecified (IBDU).

Crohn’s Disease

Crohn’s disease is a chronic inflammatory disease that affects the intestines. It most commonly causes problems in the small bowel, but it can affect any part of the gastrointestinal tract. Studies show that one-fifth of patients will require surgery for Crohn’s disease within their lifetime and 14% will need surgery in the first decade.

GI surgery may be an option for your child when nutritional changes and medications aren’t effective at providing symptom relief or preventing complications. For children who have serious damage in the lining of the gastrointestinal tract due to chronic inflammation, surgery may be the best treatment option.

Ulcerative Colitis

Ulcerative colitis is another chronic inflammatory bowel disease. It causes inflammation along the digestive tract, most commonly in the inner lining of the colon and rectum. Unlike with Crohn’s disease, the small intestine is unaffected. Children’s symptoms are usually managed with medication.

If a child doesn’t respond well to medication, surgery may be the best route. A surgical procedure can be done to remove the colon and connect a small portion of the small intestine to a remaining cuff of the colon at the anus. This is a complex surgery that may require several operations.

IBD Unspecified

This diagnosis is what doctors give to children when clinical and pathological findings do not indicate they have Crohn’s disease or ulcerative colitis, but do have similar symptoms. It’s possible that their symptoms can be managed with medication and nutritional adjustments, and surgical intervention may not be required for a child with IBDU.

Risks of Pediatric Surgery for IBD

If a child’s surgery requires that a section of the intestine be removed and reattached, there is always a small risk of leakage and scarring. When scar tissue forms, it may create a blockage in the intestine, which would require additional treatment.

The ileoanal pouch pull-through procedure used to treat UC can take a toll on children. They’ll require time to acclimate to a new bowel and intestine configuration. This is likely to result in a temporary increase in bowel movements.

There may also be minor post-surgery issues related to wound healing, but these can usually be treated with medication.

All of these issues can be quickly addressed by the dedicated surgeons and pediatric care teams at Austin Pediatric Surgery. Despite these small risks and challenges, most pediatric patients still achieve improved quality of life.

How to Prepare Your Child for IBD Surgery

It’s common for children to feel uneasy about an upcoming procedure, so it’s important to help them get comfortable with the idea and prepare them for what to expect. We recommend explaining the procedure in a simple, age-appropriate way.

Before beginning to fast, help your child make healthy eating choices leading up to the operation. Include lots of fresh fruits and vegetables and lean protein.

Your surgeon may prescribe laxatives prior to surgery, so you may need to make schedule adjustments in order to accommodate your child’s needs. It’s important to follow the surgeon’s instructions as closely as possible because they will be tailored to your child’s needs.

What to Expect During Recovery

You should make every effort to follow the recovery instructions provided by the surgeon. If your child develops a fever, bleeding, redness, constipation, or persistent nausea or vomiting, contact our office right away.

Pediatric patients with inflammatory bowel disease should be consistently monitored by a doctor. Studies show that 30% of patients can present symptoms again within three years and 60% can experience symptoms again within ten years. Because of this, it’s very important that children see their pediatrician or GI specialist regularly and that their care is transferred to an adult specialist as they get older.

Trust Austin Pediatric Surgery for Your Child’s Surgery

When it comes to IBD, our team at Austin Pediatric Surgery is committed to improving children’s symptoms and helping them get back to their normal lives. You can trust us to offer your child the most up-to-date medical treatments and partner with you and your child’s gastroenterologist every step of the way. If you have any questions about your child’s IBD surgical needs, please contact our pediatric surgery center.

Everything You Need to Know About Your Child’s GI Surgery

Posted on April 12, 2023 | by Laura Granfortuna

Preparing for your child to undergo pediatric surgery can be nerve-wracking. You may have a lot of questions and fears.

That’s okay! Our team of Austin’s best pediatric surgeons has immense compassion for what you’re going through and how you’re feeling.

We’ve compiled this resource to help you understand what to expect and how to prepare for your child’s gastrointestinal surgery.

“Undergoing surgery while they’re young can greatly improve their quality of life now and prevent even greater risks later in life.”

Pediatric GI Conditions that May Require Surgery

Our surgical team is equipped to correct many different pediatric GI issues. Some of the more common ailments are appendicitis and tumors, as well as issues involving the esophagus, stomach, and intestines.

Appendicitis

Appendicitis is the most common pediatric GI surgery. Your child may have belly pain, vomiting, and a fever. If appendicitis is diagnosed, this requires appendicitis surgery to remove it.

Intestinal Obstruction or Blockage

A bowel obstruction can occur when part of the intestine is blocked due to a tumor, scar tissue, or another obstruction. Food and stool may be unable to pass through the intestine, leading to serious complications.

Meckel’s Diverticulum

Meckel’s diverticulum occurs when the child’s small intestine has an outpouching in the wall. It’s only found in about 2% of the population and is the most common congenital intestinal malformation.

The Risks of GI Surgery

While every type of surgery carries some level of risk, consenting to have your child undergo gastrointestinal surgery is a big decision. It’s important to be informed of the risks.

Anesthesia risks are closely tied to the child’s overall health. The more fragile their health, the higher the risk.

Some parents worry about scar tissue after surgery. Scar tissue forming after GI surgery can lead to bowel obstruction down the road. The risk is quite low (less than 2%) for appendectomy procedures and somewhat higher for other abdominal operations.

Each child’s situation is unique and may come with specific risks or complications. Consult your surgeon to discuss your child’s specific risk level.

How to Prepare Your Child for Surgery

Depending on your child’s age, they could be unphased by the prospect of surgery, or they could be experiencing anxiety related to the unknown.

Your child must know you support how they feel. Engage in open and honest communication appropriate for their age level.

If you or your child have questions, please pass these on to our staff. We want them to know their concerns are important to us.

Comfort Measures

A toddler may require simple explanations that give an overview of expectations without overwhelming the child. Prepare an elementary-age child a few days in advance to allow them to adjust to the idea. Young children may also enjoy being able to bring a special stuffed animal or blanket to the medical center on the day of surgery.

An older child may appreciate meeting the surgical team and touring the facility in advance. Teens and pre-teens should be allowed to bring comfort and entertainment gear to the hospital with them to keep their nerves at bay.

How Long Does Surgery Take?

Each patient’s needs will be different. With pediatric patients, unique challenges may present and the procedure could take longer.

Common laparoscopic surgeries and bowel resection operations can take between one and four hours. More complex diagnoses could take longer. Your surgeon will be able to provide an estimate for your child’s particular case.

Post-Op Recovery

Our team is here to support you and your child’s recovery. Here are a few standard post-op care instructions to help you provide the best care for your child.

Keep the dressing or surgical site clean and dry. Do not remove the steri-strips from the dressing.
Mild irritation, bruising, or swelling is common for the first week after the procedure.
If your child is nauseous, keep them on a clear fluid diet until it passes.
Bathing instructions may differ depending on the operation, but it’s general practice to avoid swimming and bathtubs for seven to 14 days.

Follow all medication instructions closely, and don’t hesitate to contact your doctor if you have any questions.

Keep an eye out for any of the following symptoms and call the doctor if they occur.

Fever of 101.5 or higher
Excessive bleeding, drainage, or spreading redness
Constipation lasting longer than two days
Persistent nausea or vomiting

More than 20 Years of Experience Caring for Children in Austin

Nothing is more important than the health and safety of your child. Some of the more complex gastrointestinal diagnoses can have long-term, negative effects on your child’s ability to function normally. Undergoing surgery while they’re young can greatly improve their quality of life now and prevent even greater risks later in life.

Our team of expert physicians specializes in pediatric surgical treatment. APS surgeons are committed to offering the highest quality care to achieve the best possible patient outcomes through state-of-the-art pediatric surgical services.

If you would like to schedule a consultation for your child or discuss their care with our team, please don’t hesitate to reach out! We are committed to your child’s health and your peace of mind.