Pediatric surgery is a distinctive surgical specialty, provided by highly skilled surgeons formally trained in general surgery and further trained in the intricacies of treating smaller or not fully developed patients, with unique surgical needs, including those not yet born.
The specialty’s history goes back nearly 100 years. The historic beginning is generally attributed to William E. Ladd, MD, the first chief of surgery at Boston Children’s Hospital, who in 1920 devised specific procedures for babies born with congenital disorders, and treated them in an exclusive environment dedicated to children’s surgical care.
Dr. Ladd recognized that the surgical care of children could not be the same as that used for adults for a variety of reasons. And over the course of the past century, pediatric surgery established itself as a separate specialty from the field of adult general surgery.
As the specialty of pediatric surgery matured, the outcomes for the surgical care of children benefitted dramatically from improved and more advanced surgical techniques.
There is a high volume of general pediatric surgery now being performed every year in the United States. Complex cases are often taken care of at specialized pediatric institutions like Stony Brook Children’s Hospital.
At the same time, children who require more routine surgery benefit in multiple ways from the kid-centered care provided at Stony Brook Children’s.
Here, Christopher S. Muratore, MD, chief of our Pediatric Surgery Service, answers frequently asked questions about when kids need surgery and explains why parents should seek out a fellowship-trained pediatric surgeon if their child requires a surgical procedure.
Q: Why should a child who needs surgery see a pediatric surgeon?
A: Pediatric surgeons are specially trained to treat the unique needs of children. They have expertise in treating birth defects and detecting abnormalities before birth that may require surgical intervention.
Pediatric surgeons are skilled in newborn surgery, cancer surgery, and trauma surgery — major reasons why kids need surgery.
Most important, pediatric surgeons understand the special emotional needs of children and families during these stressful events, and they deliver child- and family-centered care in a child and family friendly environment.
In fact, the American Academy of Pediatrics has a policy statement saying that when a surgical condition has been identified in a child, ideally a pediatric surgeon will address it.
Q: Do all hospitals that treat children have pediatric surgeons?
A: Unfortunately no. In many community hospitals that care for adults, surgeons who typically perform operations on adult patients will often operate on children.
These surgeons may use adult-sized instruments on a child, administer anesthesia and pain medicine in a way that isn’t optimum for a child’s physiology, or not use minimally invasive procedures customarily performed by pediatric surgeons. And that can lead to unnecessary discomfort and longer recovery times.
Medical diagnoses and treatments — and even some surgical tools — need to be specialized for a child's developmental stage and size.
Q: What kind of training do pediatric surgeons have?
A: All of the pediatric surgeons at Stony Brook Children’s are board certified and have completed residency training in general surgery plus additional fellowship training in pediatric surgery.
Each of our team’s surgeons meets all the rigorous standards of training required of pediatric surgeons as defined by the American Academy of Pediatrics, the American College of Surgeons, and the American Board of Surgery.
Q: What types of procedures do your pediatric surgeons perform?
A: Everything from the most common to the highly complex. Virtually every day we repair a hernia, remove an appendix, or excise a tumor. We take care of tiny newborns with conditions that require immediate intervention, and even have the capability to perform in utero surgeries.
What is perhaps most important, we advise parents and families when operations are not necessary or when they can be delayed.
We do minimally invasive procedures through keyhole incisions as well as traditional surgeries. And, since Stony Brook is the only American College of Surgeons verified Level 1 pediatric trauma center, we’re also the place where children who have been injured, have fallen, suffered severe burns, or been in a car or boat accident are brought for care.
Q: How many pediatric surgeons are at Stony Brook Children’s?
A: We have a team of four surgeons supported by two dedicated pediatric nurse practitioners. Each of our surgeons has both general and specialized skills. Having a team of this size with these broad skills enables us to treat all types of cases and be available to perform emergency surgery on pediatric trauma patients as well.
Q: How do you help children prepare for surgery?
A: All of our pediatric surgeons as well as our support staff are trained to help lessen children’s anxiety and keep them calm and comfortable. The Children’s hospital has a specialized team of Child Life Specialists.
Our Child Life Program can help reduce the stress that pediatric patients and their families may experience when faced with illness, medical procedures, and unfamiliar surroundings. This program offers an opportunity for children to engage in everyday childhood activities to help minimize anxiety.
The Child Life Program provides therapeutic, educational, and recreational activities to meet the unique emotional and developmental needs of children during their operation and hospital stays.
One cool example at Stony Brook Children’s is our special “kitten scanner” — one of only three in the entire Northeast — which lets kids perform a pretend CAT scan on a toy to help them prepare for their own scans.
There’s also an online pre-surgical tour that shows children and their parents what they can expect.
Q: Do you work with other pediatric specialists?
A: Our approach is team-focused, meaning we collaborate with all other pediatric specialists as needed to ensure the best outcome for the child. For example, we work closely with pediatric anesthesiologists who are specifically trained to care for children during operations, and to prevent and treat pain following surgery.
Q: Will your surgeons consult with my child’s pediatrician?
A: Yes. Regardless of who or where your child’s primary care physician is, we make sure communications are open and that your child’s doctor is kept informed every step of the way.
And because we have a team of four surgeons, we are also able to see patients in our offices in Commack, East Setauket, Smithtown, and Riverhead — so wherever you are on Long Island we’re not far away.
“Pediatric surgeons must have graduated from an accredited medical school and must have completed five years of graduate surgical education in an accredited general surgery residency program. Then, they must complete two additional years of full-time education in an approved fellowship program in pediatric surgery.
“Following completion of their two-year study in the subspecialty of pediatric surgery, they must pass a written examination to ensure that their surgical knowledge is of the highest level and an oral exam to determine their ability to manage a variety of surgical problems in infants and children.
“In order to take this examination, they must first become board certified in general surgery. After these requirements have been fulfilled, surgeons are granted a special certificate in the subspecialty of pediatric surgery. This certificate must be renewed every 10 years to ensure that every pediatric surgeon is competent and up-to-date with regard to advances in pediatric surgical care.” — American College of Surgeons
Visit our website to learn more about our Pediatric Surgery Service. For consultations/appointments with our pediatric surgeons, please call 631-444-4545.