Neonatal Surgery

Have you ever wondered why some newborns require surgery within the first few days or immediately after they are born? And what is that surgery called? Surgery performed on a newborn is called neonatal surgery.
It is performed when the baby is born with critical illnesses, like congenital heart defects, intestinal blockages, or others. Neonatal surgery is designed to meet these critical needs and provide lifesaving care to newborns.

Neonatal surgery is a specialised field of medicine that focuses on surgical procedures on newborn infants, sometimes within a few hours of birth. These surgeries are designed to address serious conditions that could impact a baby’s ability to grow and thrive if left untreated. However, the idea of surgery on a tiny patient can feel overwhelming for parents; neonatal surgery often provides life-saving solutions and a hopeful path forward.

The surgery involves surgical procedures done on newborns, usually within the first 28 days of life. These surgeries address various congenital conditions and health issues that can affect infants. Here are some common types of neonatal surgery:

• Congenital Diaphragmatic Hernia Repair: This surgery is performed if a baby is born with a hole in the diaphragm. It allows organs from the abdomen to move into the chest. This condition can interfere with lung development.

• Tracheo-oesophageal Fistula (TEF) Repair: Through this surgery, doctors repair the abnormal connection between the windpipe (trachea) and the esophagus. If this is not treated at the right time, the child may have problems breathing and eating.

• Omphalocele or Gastroschisis Repair: In this surgery, doctors close a defect in the abdominal wall where the organs are outside the body.

• Pyloromyotomy: This surgery treats a condition in which the passage from the stomach to the intestine becomes narrow, causing vomiting and dehydration.

• Intestinal Atresia Repair: This surgery is done to treat a condition where a part of the intestine is missing or blocked, which can stop normal digestion.

• Malrotation and Volvulus Surgery: This medical procedure fixes an abnormal twist in the intestines that can cause a blockage or twisting, which is an emergency situation.

• Patent Ductus Arteriosus (PDA) Ligation: This surgery is performed to close a connection between two blood vessels in the heart that usually closes after birth but remains open in some infants.

• Cleft Lip and Palate Repair: This surgery treats clefts in the lip or palate, which can affect feeding, speaking, and appearance.

• Neonatal Urological Surgery: This procedure treats issues with the urinary tract that babies are born with, such as blocked pathways.

• Neonatal Oncology Surgery: This surgery of tumours that involves the removal can develop in infants, such as neuroblastoma or teratomas.

• Vascular Ring Repair: This surgery fixes a condition where blood vessels surround and compress the windpipe or oesophagus, causing breathing or feeding difficulties.

The purpose of neonatal surgery is to treat and correct medical conditions of newborns that cannot be diagnosed, addressed, and treated while in the womb. It may also treat conditions that develop shortly after their birth.
Some babies born prematurely often require neonatal surgery to correct development issues that may affect their health, growth, or ability to function normally. It may include heart defects, digestive blockages, or problems with their lungs. By addressing these conditions, neonatal surgery is performed to improve the quality of their life, aid in normal development, and sometimes even save lives.
This medical procedure helps give these babies a healthier start by fixing or improving these conditions early on. This type of surgery requires a skilled team of specialists who understand the unique needs of newborns.

Neonatal surgical procedures are often unique to each condition. It has a variety of neonatal procedures, depending on the condition being treated. These can range from minimally invasive laparoscopic procedures to major invasive open surgery techniques. Let’s dive into neonatal surgical procedures.

• Assessment and Diagnosis

It is the first procedure where doctors conduct a thorough examination to determine the baby's condition. This may involve various tests, like imaging tests, blood tests, and consultations with specialists. After examination, your doctor may confirm the need for surgery.

• Preparation

Once the surgery is confirmed, the healthcare team prepares the baby for an operation. This may involve fasting (not eating or drinking) for a certain period and ensuring the baby is stable. Parents can witness this procedure and may meet with the surgical team to discuss the procedure.

• Anaesthesia

On the day of neonatal surgery, the baby is given anaesthesia. This ensures that the baby is comfortable and pain-free during the procedure. This procedure is usually done with a combination of medications.

• Surgery

The surgeon carefully performs the operation, which can vary greatly depending on the condition being treated.

• Recovery

After the surgery, the baby is taken to a recovery area where medical staff monitor them closely. This ensures that they are waking up from anaesthesia safely and that their vital signs are stable.

• Postoperative Care

Once the baby is stable, they may be moved to a special care unit, such as the neonatal intensive care unit (NICU), for further monitoring and support. The healthcare team provides care and may give medications as needed to help with pain or prevent infection.

• Follow-Up

After recovery, follow-up appointments are scheduled to monitor the baby's progress and ensure they are healing well. Additional treatments or therapies may be recommended as needed.

Neonatal surgery is carefully planned and performed by a team of experienced specialists like neonatal surgeons, anaesthesiologists, neonatologists, paediatric nurses, and others. This procedure is performed to address important health needs in newborns.
While every surgery has some risks, the medical team takes all necessary precautions to ensure the safest outcome for each baby. Possible risks may involve this procedure, like infection or delayed healing. But the healthcare team is closely monitored and provides dedicated care to support a smooth recovery. Neonatal surgery is the most effective procedure that helps newborns start healthier lives

After surgery, your baby will be kept in a special care area called the NICU for close monitoring. The special unit is equipped with all required amenities & equipment that your baby may need after surgery. Your baby may require oxygen support, respiratory monitors, temperature regulation, IV lines for fluids and medications, and advanced infection control measures.
Feedings will begin slowly, and the medical team will monitor for infection and other signs of recovery. The healthcare team encourages parents to spend more time with their baby. The medical team will also show you how to care for them at home when they are ready to be discharged.