An overview of neonatal and thoracic surgery

Written in association with: Mr Ashok Ram
Published: | Updated: 10/08/2024
Edited by: Conor Lynch

Neonatal and thoracic surgeries are critical fields within paediatric surgery, focusing on delicate procedures for the most vulnerable patients. In this article below, revered consultant paediatric and neonatal surgeon, Professor Ashok Ram, explains what the respective surgical fields entail and what they are used to treat. 

What is neonatal surgery?

Neonatal surgery is a highly specialised field due to the unique challenges posed by newborn patients. These challenges include the small size and fragility of neonates, their unique physiology, and the presence of congenital conditions that may require immediate intervention.

 

What are the most common types of neonatal surgery?

Common neonatal surgical procedures include correction of congenital diaphragmatic hernia, intestinal atresia, and repair of congenital heart defects. The success of these surgeries often hinges on the early diagnosis and timely intervention, which can significantly improve outcomes and quality of life for these young patients.

 

What is thoracic surgery, and when is it required?

Thoracic surgery in neonates and children requires precision and expertise to manage conditions such as congenital heart defects, lung malformations, and chest wall deformities. Surgeons in this field employ advanced techniques such as minimally invasive surgery, which involves smaller incisions and results in quicker recovery times and reduced pain for the patient.

 

Common procedures include the repair of tracheoesophageal fistula, lobectomy for congenital lung lesions, and correction of pectus excavatum. Innovations in surgical techniques and postoperative care have significantly improved survival rates and long-term health outcomes for paediatric patients undergoing thoracic surgery.

 

One of the critical aspects of neonatal and thoracic surgery is the multidisciplinary approach. Surgeons work closely with neonatologists, paediatric anesthesiologists, cardiologists, and other specialists to provide comprehensive care. This team approach ensures that all aspects of the child's health are considered, from preoperative planning to postoperative care and long-term follow-up.

 

Advances in neonatal and thoracic surgery have been driven by improvements in prenatal diagnostics, surgical techniques, and postoperative care. Prenatal imaging techniques, such as foetal MRI and ultrasound, allow for early detection of anomalies, enabling surgical teams to plan interventions even before birth. Moreover, the development of specialised surgical tools and techniques tailored for paediatric patients has enhanced the precision and effectiveness of these procedures.

By Mr Ashok Ram
Paediatric surgery

Mr Ashok Ram is an experienced consultant paediatric and neonatal surgeon who practises at the Norfolk and Norwich University Hospital. He trained in major paediatric surgical centres across the UK and obtained his CCT in paediatric surgery after which he joined the Paediatric Surgical Department in Norwich.

His practice is the general surgery of childhood and he sub-specialises in neonatal surgery, thoracic surgery and upper gastrointestinal surgery. He is also a staunch educationist and holds the positions of honorary associate professor at the Norwich Medical School of the University of East Anglia, regional training director, director of advanced paediatric life support, faculty for the European paediatric advanced life support courses and surgical skills courses (basic surgical skills, laparoscopic skills, pre-hospital and emergency resuscitative thoracotomy, specialty skills for emergency and trauma) from the Royal College of Surgeons of England.

He is an executive member of the Education Committee of the European Society of Paediatric Endoscopic Surgeons. He conceptualised, founded, directs, and teaches on the SPRINT (International Paediatric Surgical Training Programme), a virtual forum which holds seminars and postgraduate exam preparation sessions attended by paediatric surgeons and trainees worldwide. He has presented his work at numerous national and international meetings and conferences and authored multiple chapters in various paediatric surgical textbooks and journals.

He received the Gold Medal from the European Board of Paediatric Surgery as a candidate to which he has now joined as an Examiner. He has also won multiple awards nominated by patients and students alike.

Many paediatric and neonatal surgical conditions are best seen and managed in the NHS setting where he is a full-time consultant. The following are some of the conditions that may be suitable for consultation and management in his private clinic and settings: abdominal conditions, abdominal pain, acid reflux, chest deformities (pectus carinatum and excavatum), congenital malformations, constipation, gastrointestinal conditions, groin conditions, head lesions, hydrocele, inguinal hernia, laparoscopy, nail diseases, neck lesions and swellings, neonatal surgery, perianal conditions, phimosis and circumcision, thoracic conditions, tongue tie, umbilical hernia, undescended testicle, and upper GI endoscopy. 

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