When the doctor calls

It’s a situation we all want to avoid, but sometimes kids need surgery too. We spoke to Dr. Ghassan Nakib about minimally invasive surgery for kids and what you need to know when it comes to the crunch

Interview, Health

It’s a situation we all want to avoid, but sometimes kids need surgery too. We spoke to Dr. Ghassan Nakib about minimally invasive surgery for kids and what you need to know when it comes to the crunch.

When you find out your child needs an operation, it’s a worrying time. You’re concerned not only about his health, but about the anaesthetic required for surgery, how much pain he’ll be in, the length of recovery and how much school he’ll miss, whether the operation will leave a scar...the list goes on.

The good news is that many common childhood conditions can now be operated on using minimally invasive surgery. Among others, these include appendicitis, hernias, undescended testicle, severe reflux and various congenital issues.

What is minimally invasive surgery?
Minimally invasive surgery (sometimes called keyhole or laparoscopic surgery), first came into use in the 1990s and is a proven and well-tested surgical technique. It is a method of carrying out an operation without having to make a large incision. Although your child will still probably require a general anaesthetic, it has many benefits when compared to standard open surgery including a smaller incision with minimal scarring, a quicker recovery time, lower risk of infection and a shorter hospital stay, all of which go to making the whole experience less traumatic for both parents and patient.

What does minimally invasive surgery involve?
Before the procedure, your child will be given a general anaesthetic and will feel nothing during the operation. Once your child is asleep, the surgeon will insert a small metal tube called a cannula into the tummy button, if the operation is being conducted on the abdomen. A telescope with a miniature camera which can project very high-quality video images is inserted into the cannula. The abdomen is then inflated with carbon dioxide to allow the surgeon room to operate. The operation is performed using special instruments which are inserted through additional very small holes. When the operation is finished, the surgeon, if required, will stitch up the incisions and your child will go to the recovery room to wake up. Your child should recover quickly, be able to leave hospital soon after and be back at school as soon as they feel well, generally after about a week.

Are there any risks associated with keyhole surgery?
The standard risks of complications associated with anaesthetics apply to keyhole surgery, but these are very rare. As with any operation, there is also the risk of infection, but this is reduced because smaller incisions are used. Very occasionally the tools used may cause some damage to surrounding organs, but this can usually be fixed during the operation itself. It is possible your child may also experience some shoulder pain which will pass without the need for further treatment.

How do I choose a surgeon for my child?
If surgery is necessary for your child, you should choose your surgeon carefully. Children are not small adults. They differ anatomically, physiologically and emotionally and suffer from distinct diseases and conditions. An experienced paediatric surgeon will be able to advise you on the indicated surgical treatment for your child; minimally invasive surgery will only be recommended if it can be carried out as safely and effectively as open surgery.
Dr. Ghassan Nakib is a consultant paediatric surgeon at Mediclinic City Hospital. He is Italian board certified in Paediatric Surgery and received his Masters in Paediatric Laparoscopic Surgery from the University of Bologna, Italy.

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