Neonatal Surgery

What is neonatal surgery?

Neonatal surgery encompasses a wide range of surgical procedures performed on newborns. Newborns will need surgery if the condition is life-threatening and is often extremely rare; however, some conditions that are operated on are relatively minor problems. Some of these conditions will have been detected before birth on routine scans, but others will not be detected until after birth or will develop in the weeks that follow.

Why is neonatal surgery performed?

Conditions found on pregnancy scans are often the result of inadequate development of the baby.

For example, exophallus is one of the conditions that neonatal surgeons operate on. This condition is caused by improper development of the belly wall, which causes the intestine to remain on the outside of the baby’s body. Again, the severity of this can vary from minor to complex.

Another condition commonly treated by neonatal surgery is gastroschisis, in which a hole develops in the stomach wall next to the umbilical cord, allowing the intestine to float freely in the amniotic fluid, coming into contact with the baby’s urine and feces, which can cause inflammation. Therefore, surgery is needed to ensure that the bowel is returned to the abdominal cavity and the hole is closed.

The following conditions are those that may develop suddenly very soon after birth and may need surgery:

  • Necrotizing Enterocolitis (NEC): inflammation and infection of the bowel.
  • Atresia: intestinal obstruction.
  • Hernias: these may develop in the groin after birth.
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Intestinal problems often require neonatal surgery to avoid serious complications in the baby’s development.

What is neonatal surgery?

Surgery will depend on the type and complexity of the condition. For example, more complex cases of exophallus may require several surgeries to fully treat. This is known as staged repair and will involve an operation to wrap the outer intestine, with additional surgeries needed to repair the stomach wall. Additional surgeries may be needed to repair hernias that arise as a result of previous surgeries.

Some babies may need to be kept on a ventilator to help them breathe. For these procedures, pain medication is given to the baby to control pain.

How do you prepare for neonatal surgery?

Having a newborn baby who requires surgery can be an emotional and difficult reality for parents to cope with, and as much as possible, the medical team treating your baby will be there to provide information, support and regular updates on your baby’s progress. There are also special neonatal centers throughout the country.

Care after neonatal surgery

After the operation, the surgeon will be aware of what the baby’s recovery may be like, which can give parents a rough set of expectations from the surgery. However, the baby’s neonatal surgery will require hospitalization and 24-hour monitoring to ensure that if any complications arise they can be resolved. After discharge from the neonatal ward, your baby will need frequent check-ups to monitor his or her progress.