AREAS OF EXPERTISE
Paediatric Surgery is a surgical specialty that deals with diseases, trauma, and malformations in children from the fetal period to teenage years
Paediatric Urology is a branch of practice that offers diagnosis and specialty care for a wide range of developmental and acquired problems affecting the kidneys, bladder, urethra or genital tract.
Laparascopy also known as "keyhole surgery" or "minimal invasive surgery" is an operation performed in the abdomen or pelvis using small incisions (usually 0.5–1.5 cm) with the aid of a camera without the need of "opening- up" the patient.
Endourology is a branch of urology that uses small endoscopes and cameras to view and treat the urinary tract.
Surgical oncology is the branch of surgery dedicated to cancer; it focuses on the management of tumors that require surgery for diagnosis or treatment.
Surgical training is an apprenticeship skill that involves clinical instruction and mentorship to trainees with a view to advance and standardize the practice of surgery.
Clinical research is branch of medical research that aims to determine the effectiveness (efficacy), and safety of medications, devices, diagnostic products, and treatment regimens intended for improving health
COMMON CONDITIONS IN PRACTICE
Inguinal hernias occur when a piece of intestine or other organs in the abdomen slips through a hole in the abdominal wall around the groin. They are usually noticed when children cry, cough, or strain and are recognized as a soft swelling underneath the skin in the groin, labia or scrotum. Occasionally hernias can get incarcerated or ‘stuck’. All hernias are treated by surgery, and it is important that surgery is performed soon after hernias are diagnosed to prevent incarceration.
Like inguinal hernias, hydroceles are also caused by a ‘hole’ in the abdominal wall, however unlike hernias, hydroceles only accommodate fluid from the abdomen and not intestines or other organs. Hydroceles are usually present as a painless, swollen testicle. Most hydroceles resolve spontaneously by the age of 2 years. They are most common in preterm males, and can occur on both the right and left sides. Large hydroceles, and those that persist beyond 2 years of age will require surgical correction.
An umbilical hernia occurs when part of the baby's intestine bulges through the opening in the abdomen around the baby belly button (navel). The typical appearance is a bulging navel. Like inguinal hernias, umbilical hernias can incarcerate leading to symptoms such as abdominal pain, reduced appetite, irritability and vomiting. Umbilical hernias will require surgical management if they are associated with symptoms.
The testes are formed prior to birth and gradually descend from the abdomen to the scrotum during pregnancy. Occasionally, testicular descent is incomplete, and boys can have testis that are not in the scrotum. Undescended testicles can occur on one or both sides and they are associated with multiple complications including infertility, testicular torsion, inguinal hernia, and testicular trauma that may be recognized and avoided through timely surgery. Surgery (orchidopexy) should be performed before the age of 1 year.
Circumcision is commonly performed on cultural or medical grounds. The age can range from neonates to older children. The most common medical reasons to perform circumcision include phimosis, balanitis and risk of urinary tract infections. Most children go home on the day of surgery
Hypospadias is a congenital abnormality resulting in an abnormal urethral meatus, skin coverage and curvature of the baby penis. Essentially the opening of the urethra (urine pipe) is not located in its normal position at the tip and this results in abnormal urination and reproduction. Hypospadias is usually diagnosed after birth and is corrected surgically. Surgery depends on the severity of the defect and is usually performed between 4 and 18 months of age.
Posterior urethral valves (PUV) are obstructive membranes that develop in the tube that drains urine from the bladder(urethra). The valve can obstruct or block the outflow of urine through the urethra (urine tube). Children with PUV have difficulty and pain on urination, increased risk of UTI and increased risk of kidney damage. The treatment of PUV depends on severity with the goal of preserving the kidney and the bladder. The standard surgical procedure is endoscopic valve resection.
Incontinence in children refers to the lack of controlling passage of urine. It may show as a child being unable to be fully potty trained or may occur in a child that previously had bladder control issues. The assessment of the child involves a series of questions, a physical exam and special radiologic investigations. Treatment of urinary incontinence in children is complex and often may involve behavior modification, medical therapy and occasionally surgery.
Occasionally bedwetting (nocturnal enuresis) may be a concern to the family, in such cases an expert opinion should be sought.
Constipation is a common problem for children. Many children have constipation at one time or another. Being away from home, and changes in diet and activity are some of the most common causes of constipation in young children. Children with constipation may experience abdominal pain, swollen tummies, and pain when passing stool. Important warning signs to look out for are a reliance on enemas to pass stool, a child that is not growing appropriately and a child that did not pass their first stool within the first 2 days of life. Sometimes severe constipation can lead to stool soiling of underwear and incontinence of urine during the day.
Appendicitis is inflammation and infection of the appendix, a small piece of tissue located on the lower right side of the abdomen (belly) and attached to the large intestine. Children often experience vague belly pain that moves from the middle of the abdomen to the right lower side. The pain gets worse with time and can be associated with decreased appetite, vomiting, diarrhea, and fever. The treatment is surgical removal of the appendix commonly known as appendectomy.
Intussusception is a condition in children where one part of the intestine tunnels into an adjacent part of the intestine and gets stuck. This results in a blockage that prevents food or fluid from normally passing through the intestine. If left untreated, intussusception can be extremely dangerous. Children with intussusception have severe crampy abdominal pain with periods of rest. They may vomit or pass bloody stool with mucus. All children with intussusception require admission and stabilization while the intussusception is addressed by a surgeon.
Testicular torsion is the twisting of the tube, called the spermatic cord, which leads to the testicle. When the blood vessels are twisted, they can cut off the blood supply to the testicle and cause permanent damage. Testicular torsion can happen at any age. However, it is most common in newborns or boys going through puberty. The testicle can survive for only about six to eight hours without any blood flowing to it and therefore the condition requires emergency surgery. After that, the tissues are damaged and the testicle no longer works. This condition is a surgical emergency.
Hydronephrosis is the swelling of one or both kidneys. Kidney swelling happens when urine can't drain from the kidney and therefore builds up in the said kidney. This can occur from a blockage in the tubes that drain urine from the kidneys (ureters) or from an anatomical defect that doesn't allow urine to drain properly. To determine the cause, the doctor will order some special radiological tests on the child and treatment will depend on the cause. Left untreated, severe hydronephrosis can lead to permanent kidney damage
Urinary stones are hard masses of minerals in your kidney, ureter or bladder. They can cause symptoms such as abdominal pain and blockage of urine flow including problems with urination. Left untreated, stones can lead to infections, kidney damage and other complications. Treatment may include medications or surgery.
INFORMATION FOR PATIENTS