What to Expect with Pediatric Gastrointestinal Surgery

Hearing your child needs gastrointestinal (GI) surgery can be one of the most frightening experiences a parent can face. The complexity of the digestive system, combined with the natural anxiety that comes with any surgical procedure involving your child, creates a perfect storm of worry and uncertainty. 

However, knowing what to expect from this procedure can provide reassurance during a stressful time. Here’s the basic info you’ll need to understand pediatric gastrointestinal surgery. 

Understanding Pediatric Gastrointestinal Surgery

Pediatric GI surgery encompasses a broad range of procedures designed to treat conditions affecting the digestive tract (from the esophagus to the rectum) in children (from newborns to teenagers). Unlike adult gastrointestinal surgery, pediatric procedures must account for the unique anatomy and physiology of growing children and require specialized expertise and techniques.

Common Conditions That May Require Pediatric GI Surgery

Children may require GI surgery for several reasons, some urgent and some planned. Common conditions include:

• Malrotation and volvulus: A twisting of the intestines that can cut off blood flow and lead to a life-threatening emergency. Prompt surgery is critical.
• Bowel obstructions: These can be caused by congenital abnormalities, scar tissue, or other factors that prevent food and fluid from moving through the intestines.
• Meckel’s diverticulum: A congenital abnormality, where a small pouch in the wall of the intestine can become inflamed or bleed, sometimes requiring removal.
• Hirschsprung’s disease: A condition where part of the bowel lacks nerve cells, causing severe constipation or obstruction.
• Appendicitis: In children, it often requires urgent attention and surgical removal of the appendix.
• Necrotizing enterocolitis (NEC): A serious condition affecting premature infants where portions of the bowel become inflamed or die.
• Gastroesophageal reflux disease (GERD): In severe cases, surgery may be needed to prevent acid reflux from damaging the esophagus.

Each condition requires a different approach, but all fall under the umbrella of pediatric GI surgery, which aims to restore healthy function to your child’s digestive system.

Preparing for Surgery: What Parents Should Know

The journey through pediatric GI surgery begins long before your child enters the operating room. The pre-surgical process is designed to ensure that your child is in optimal condition for surgery and that you, as parents, are fully informed and prepared for what lies ahead.

Once surgery is recommended, your pediatric surgical team will provide detailed information tailored to your child’s condition. Here are the general steps involved in the process:

Consultation and Diagnostic Testing

A pediatrician or specialist may refer your child to a pediatric surgeon after imaging (ultrasound, X-ray, or MRI) or lab tests suggest a GI problem. Depending on your child’s condition, additional tests may be necessary, including blood work, imaging studies (ultrasound, CT scans, or MRI), contrast studies, and occasionally, endoscopic procedures. The pediatric surgeon will review these findings and explain whether surgery is necessary.

Pre-Operative Preparation

Before surgery, your child will undergo a pre-operative assessment to ensure they’re ready for anesthesia and surgery. This includes reviewing medications, discussing any allergies or previous reactions to anesthesia, and providing specific instructions about eating and drinking before surgery.

Discussion of Risks and Benefits

The surgeon will walk you through the procedure, including potential risks, benefits, and recovery expectations. Pediatric GI surgery is performed with extreme care and precision using techniques designed for young bodies and growing organs.

Multidisciplinary Team Approach

Modern pediatric GI surgery involves a team of specialists working together to provide comprehensive care. This team typically includes pediatric surgeons, pediatric anesthesiologists, specialized nurses, nutritionists, and, when necessary, other specialists, such as pediatric gastroenterologists or neonatologists.

Preparing Your Child for Surgery

Helping your child prepare for surgery is an important part of the process. Children of different ages have different needs and concerns, and a pediatric surgeon’s approach to preparation is tailored to each child’s developmental stage.

Age-Appropriate Explanations

For younger children, your surgeon might use simple terms and picture books to explain what will happen during surgery and hospitalization. Meanwhile, older children and teenagers can understand more detailed explanations.

Addressing Fears and Concerns

It’s normal for children to have fears about surgery. Pediatric surgeons typically encourage parents to discuss these concerns openly and honestly. Child life specialists can provide additional support and use techniques, such as medical play, to make children feel more comfortable.

Involvement in Care

When appropriate, pediatric surgeons involve children in their own care. This might include allowing them to choose which arm to use for an IV or to help with simple aspects of their care. This involvement can help children feel more in control and less anxious.

What Happens During Surgery

Understanding what occurs during your child’s surgery can help alleviate some of the anxiety surrounding the procedure. While each operation is unique, the following are the common elements of most pediatric GI surgeries.

Anesthesia 

Pediatric anesthesia has become remarkably safe, with anesthesiologists who specialize exclusively in children. Your child will be given medications to ensure they’re completely comfortable and unaware during the procedure. Modern anesthesia techniques are designed to minimize side effects and promote rapid recovery.

Surgical Approach

Whenever possible, pediatric surgeons utilize minimally invasive techniques, including laparoscopy and robotic surgery. These approaches use small incisions and specialized instruments to perform the same procedures that once required large incisions. The benefits include less pain, smaller scars, shorter hospital stays, and faster recovery times.

Monitoring and Safety

Throughout the procedure, the anesthesia team continuously monitors your child’s vital signs. They use advanced monitoring equipment to track heart rate, blood pressure, oxygen levels, and other important parameters to ensure your child’s safety throughout the operation.

Communication with Family

During longer procedures, the team ensures updates are provided to family members. Nursing staff are trained to keep families informed about the progress of the surgery and estimated completion times.

Post-Operative Care and Recovery

The recovery period following pediatric GI surgery is crucial for achieving the best possible outcomes. Post-operative care is designed to manage pain effectively, prevent complications, and promote healing while keeping both children and parents as comfortable as possible.

After surgery, your child will be closely monitored in a recovery area, and in some cases, in a pediatric intensive care unit (PICU), especially if they are a newborn or medically fragile.

Recovery timelines vary depending on the procedure and your child’s overall health, but here’s what to expect:

• Pain Management: Pediatric teams are skilled in managing pain safely and effectively.
• Gradual Reintroduction of Feeding: Your child may start with IV fluids. Then, slowly move to oral feeding as bowel function returns.
• Incision Care: Nurses will teach you how to care for the surgical site to prevent infection.
• Activity Guidelines: Restrictions on activity will depend on the surgery, but most children return to normal activities within a few weeks.

Your surgical team will provide follow-up appointments to monitor healing and answer any ongoing questions.

Long-Term Outlook

The goal of pediatric GI surgery is not just to address the immediate problem but to ensure that children can grow and develop normally. Most children recover well after pediatric GI surgery and go on to live full, healthy lives. For some conditions, such as Hirschsprung’s disease or NEC, ongoing care and monitoring may be necessary to support nutrition, growth, or bowel function.

Your surgical team will connect you with pediatric gastroenterologists, dietitians, or therapists as needed.

• Follow-Up Care: Regular follow-up appointments are essential in monitoring your child’s recovery and developmental milestones. The frequency of these visits depends on the type of surgery performed and your child’s individual needs. Some children may require only a few follow-up visits, while others with more complex conditions may need ongoing monitoring.
• Growth and Development: Many children who require pediatric GI surgery have experienced growth delays or nutritional deficiencies related to their underlying condition. After successful surgery, most children experience catch-up growth and improved nutritional status. 
• Activity Restrictions: While most children can return to normal activities relatively quickly after surgery, some procedures may require temporary activity restrictions. These restrictions are designed to promote healing and prevent complications.

The Importance of Choosing the Right Surgical Team

The success of pediatric GI surgery depends heavily on the experience and expertise of the surgical team. When choosing a surgeon for your child, it’s important to select someone who specializes in pediatric surgery and has specific experience with your child’s condition.

• Board Certification: Look for surgeons who are board-certified in pediatric surgery. This certification requires completion of specialized training in pediatric surgery and passing rigorous examinations.
• Hospital Accreditation: Choose a hospital that has been accredited as a pediatric surgical center. These facilities have the specialized equipment, nursing staff, and support services essential to provide optimal care for children.
• Experience with Your Child’s Condition: Some pediatric GI conditions are relatively rare, so it’s important to choose a surgeon who has experience with your child’s specific condition. Don’t hesitate to ask about the surgeon’s experience and outcomes with similar cases.
• Communication Style: It’s important to choose a surgeon who communicates effectively with both you and your child. The surgical team should be willing to answer questions, explain procedures in terms you can understand, and involve you in decision-making about your child’s care.

If your child has been diagnosed with a condition that may require GI surgery, don’t hesitate to ask questions and seek support. Understanding the process is the first step toward confidence and peace of mind.

Have Questions About Pediatric GI Surgery?

Our team is here to guide you every step of the way—from diagnosis through recovery. Contact Pacific Coast Pediatric Surgery today to schedule a consultation or get a second opinion from an experienced pediatric surgeon. Your child’s health is our top priority.