The subject of Pediatric Surgery
The subject of Pediatric Surgery includes prevention and treatment of surgical congenital malformations and acquired diseases occurring from the fetal period up to the age of 16 years (as defined by the law and relevant provisions). Traditionally, the specialty of Children's Surgery deals with all body systems other than cardiovascular. However, the rapid evolution of specialties has removed certain areas from the current Pediatric Surgery practice, while in the same time has greatly increased the potential in the areas that remain within it.
It is important to emphasize that, although Pediatric Surgery can be considered a specialty of Surgery, it is nevertheless an independent discipline, requiring prolonged special training. This is due to the fact that children very often suffer from completely different illnesses than those seen in adults and that they can not be considered as an adult miniature but as a developing organism with many special needs. We also need to emphasize the inextricable relationship between Pediatric Surgery and Pediatrics, since they are aimed at individuals of the same age groups. Also, there is a considerable overlap of symptoms in diseases concerning both specialties.
Finally, we have to mention two sciences within the group of "basic sciences", which influenced Pediatric Surgery critically, mainly as regards the causes of the diseases and their prevention. These are Genetics and Embryology.
Technological development has not left the Pediatric Surgeons indifferent, although there has been a relative lag in the application of modern techniques such as laparoscopic surgery and robotic surgery in particular, compared to General Surgeons. It is widely believed that fetal surgery has not yet yielded the fruits expected of it. Especially for robotics and fetal surgery, but also for many other individual applications, much is to be expected from the present students if they specialize in Pediatric Surgery.
Upon successful completion of the course, the student should:
- Recognize and respect the particular emotional and ethical issues relating to the care of sick children.
-Understand that although the fundamental principles of children's surgical care are the same as those governing older people, there are also important differences that need to be taken into account, especially when it comes to neonates and infants. These mainly concern physiology and anatomy issues. It is extremely important to understand that many pediatric surgical problems are more appropriately addressed where there are special pediatric facilities that provide expertise not only in surgery but also in anesthesia, intensive care, diagnostic imaging, laboratory support and nursing care.
- Be aware of the pathology and symptomatology of major and more frequent surgical conditions of neonates and older children.
- Be able to take history, family history, conduct clinical examination and perform targeted laboratory investigation of the cases.
- Be able to draw up a list of differential diagnosis and then propose further investigation in order to narrow the list of differential diagnosis. Also to suggest a way of dealing with the patient, knowing which treatment options are available, including non-surgical. Assess whether the patient can be treated in the context of primary care, or should be referred to a specialized center, urgently or in due time.
- Be able to respond to the patient's immediate needs, with appropriate handling, administration of water, electrolytes, drugs, either in the context of preoperative optimization, or in case of urgency. To ensure that the patient is quickly and safely processed when necessary. To recognize post traumatic and post-operative complications.