Paediatric Surgery

The main purpose of neonatal surgery is to correct congenital malformations.

UKBB specialises in treating the following problems, amongst others:

• Abdominal wall defects (omphalocele, gastroschisis)

• Oesophageal atresia (absence or abnormal narrowing of the windpipe)

• Congenital diaphragmatic hernia

• Lung malformations

• Stenosis/atresia of the small and large intestine

• Malrotation/volvulus (twisted bowel)

Our surgical team is particularly experienced in treating

• Anal and rectal malformations

• Hirschsprung's disease

Most of these diseases can be detected before birth with the help of ultrasound scans. After consultation with the parents and the provision of full information, many malformations are operated on in the first days of the baby's life.

If possible and appropriate, operations are carried out using minimally invasive techniques. In order to ensure the best possible care for the child, our paediatric surgeons work closely with colleagues from neonatology, anaesthesiology and paediatric gastroenterology.

General paediatric surgery covers some of the following disorders:

• Inguinal hernia
• Umbilical hernia
• Undescended testicles
• Neck fistulas
• Weeping navel (urachus cyst, fistula)
• Dermoid cyst
• Ear tag (pre-auricular appendage)
• Pilonidal sinus

If possible and appropriate, the operations are carried out using minimally invasive techniques.

Most operations can be performed on an outpatient basis: your child is admitted to the hospital in the morning, undergoes surgery and is discharged on the same day.

This type of surgery involves the treatment of gastrointestinal disorders.

These include, for example:

• Appendicitis (inflammation of the appendix)
• Gastroesophageal reflux
• Cholecystolithiasis (gallstones)
• Hypertrophic pyloric stenosis
• Accident-related injuries to the organs of the abdominal cavity (e.g. spleen, liver, pancreas)

In most cases, these procedures can be performed using minimally invasive techniques.

Our surgical team is particularly experienced in treating

• Chronic bowel inflammation (Crohn's disease, ulcerative colitis)
• Short bowel syndrome

In order to ensure the best possible care for your child, our paediatric surgeons work closely with colleagues from UKBB's paediatric gastroenterology team.

UKBB's paediatric surgeons treat injuries to the soft tissue (skin, vascular system, nerves and tendons) using the very latest standards and scientific knowledge. Skin wounds, for example, are glued rather than sewn together, which is much less invasive. This means there is no need to anaesthetise the skin later with an injection and remove the stitches, which can sometimes be painful. In addition, many bone fractures are not treated with surgery but by "conservative" measures: the specialist straightens the bone and then sets it in plaster. The patient must not put any pressure on the fracture for 2 to 3 weeks.

With older children and adolescents, bone fractures are sometimes stabilised with wire or pins so that pressure can be loaded onto the damaged part of the body sooner.

If this type of surgery is necessary, only a one-day stay in hospital is usually required.

Typical neurological disorders and malformations treated and operated on at UKBB include some of the following:

• Malformations of the kidneys and the urinary tract (urethral crest, hypospadias/epispadias)
• Testicular varicose veins (varicocele)
• Urinary incontinence and bladder-emptying disorders
• Inguinal hernia
• Fluid in the scrotum (hydrocele)
• Backflow of urine from the bladder towards the kidney (vesicoureteral reflux)
• Testicular tumours
• Undescended testes (cryptorchidism)
• Tightening of the foreskin (phimosis)

Some of these problems can be identified in the womb using ultrasound. Most operations for these disorders and malformations are performed on an outpatient basis: your child is admitted to the hospital in the morning, undergoes surgery and is discharged on the same day.

Thoracic surgeons are skilled in the treatment of congenital or acquired malformations of the lung (e.g. congenital pulmonary airway malformation (CPAM) or pulmonary sequestration), inflammatory changes in the lung (e.g. abscesses), chest deformities (funnel chest, pigeon chest) and lung tumours or metastases.

Plastic surgery
Paediatric plastic surgery includes the correction of malformations of the face, skull, ears (e.g. protruding ears), thorax and extremities. Paediatric plastic surgeons treat patients with vascular malformations, deformations of the external sensory organs, scars, burns, consequences of accidents and large moles. They are involved in reconstruction after tumour treatment and in cases of injuries to the face, hands, arms and legs.

Aesthetic corrections that are important from both a psychological and social perspective can help to substantially improve the self-esteem of children and adolescents. Paediatric plastic surgeons support families in deciding whether such corrections are appropriate.

Paediatric plastic surgery at UKBB uses a multidisciplinary approach. Many special treatments are carried out in collaboration with several surgical specialists. Maxillofacial surgery and neurosurgery take the lead in the treatment of patients with craniofacial malformations and cleft lip/jaw/palate. Colleagues in paediatric surgery focus on urogenital malformations, angiomas and thoracic deformities, and simpler burns and scalds. Malformations of the upper and lower extremities are corrected in collaboration with paediatric orthopaedics and hand surgery.

Close collaboration between all these highly specialised teams assures the optimal treatment for children at UKBB. Patients referred to our hospital benefit from highly motivated interdisciplinary care with modern treatment methods built on a pool of international expertise.

Hand surgery
UKBB has the infrastructure needed to treat any hand injury in an emergency, as well as the residual consequences of accidents, in accordance with modern guidelines. A 24-hour replantation service and a specialist hand surgery team are available around the clock, operating in conjunction with the Clinic for Plastic, Reconstructive, Aesthetic and HandSurgery at University Hospital Basel.

Modern microsurgery, arthroscopic and plastic surgery, as well as orthopaedic techniques, are used to treat injuries – if possible in a minimally invasive way. Here an environment suitable for children is essential and helps to ensure effective rehabilitation.

Hand malformations are rare overall and can be problematic due to the potentially negative effects on children. The hand surgery team therefore continues to support families with affected children from the prenatal ultrasound right through to adulthood. The treatment is carried out at major international centres for children's hand malformations in London, Hamburg and Japan, with which there is regular exchange. From psychological support to prostheses and free digit transfers: all available techniques are employed in order to enable the affected patients to achieve the best possible quality of life and independence despite their hand malformation.

If necessary, treatment can also continue in adulthood by the same specialised teamat University Hospital Basel.

The specialist hand surgery consultation is held every week in the outpatient department at UKBB.