Q. How is a children's hospital different from an adult hospital? 

 A. A children's hospital is planned around the special needs of children and their families. All of the doctors have special training in pediatrics, whether they're pediatric surgeons or pediatric anesthesiologists or pediatric radiologists; all of the nurses are experienced in caring for children. This concentration allows us to develop specific expertise in pediatric problems, and to develop special programs for children (such as Minimal Access surgery, pediatric trauma care, etc.) 
 
 
 
 

 

Q. Why did my baby get a hernia? 

 A. In boys, the testicles develop near the kidneys; they travel down to the scrotum during the end of gestation. The "pathway" they leave behind them is called the processus vaginalis; its equivalent exists in girls, with the end of the pathway being the labia. This pathway normally closes by the time of birth. If it remains open, then the contents of the abdomen may potentially also travel down through it. If abdominal fluid passes down to the scrotum, this is called a hydrocele or a communicating hydrocele; if an ovary (in a girl) or intestines are involved, this is termed a hernia.  More about hernias and hydroceles...   
     
 
 
 

  
 

Q. My child is scheduled for an outpatient hernia repair. How long will she take to recover from her surgery? How do I take care of the incision? 

A. Most children recover from outpatient procedures like a hernia repair in a remarkably short time, often just a day or two.  We are experienced in making our surgical dressings "child-proof," and most don't require any special attention from parents--either we will remove it at your follow-up visit or it will fall off by itself.  We usually use absorbable stitches, so generally there are no stitches to remove either.  In general, you don't need to restrict your child's activities after hernia surgery.  Your surgeon will give you individualized instructions about bathing, swimming, etc. 

  
 
 

Q. What I'm really worried about is the anesthesia. Is it safe to give small children general anesthesia? 

 A. At the Babies & Children's Hospital of New York, all our patients are cared for by Pediatric Anesthesiologists.  Like the other pediatric specialists here, they have all done additional training to care for children.  While we can't make parents stop worrying altogether, we can reassure you that general anesthesia given to even premature babies by a qualified anesthesiologist is very safe--statistically safer, in fact, then driving on an average highway. 

  
 
 

 

Q. Who is actually going to perform my child's surgery? (I know that Columbia is a teaching institution--is some trainee going to do the procedure?) 

 A. Every procedure performed in the operating room at Babies & Children's Hospital is conducted from start to finish by one of the fully qualified staff surgeons.  "Conducting" an operation is a bit like conducting an orchestra: you need a number of people to get the job done, but the conductor (the surgeon) determines exactly what gets done, and by whom, and when.  So we are often assisted by residents, and (in fact) could not physically do many of the more complex procedures without their help. 

  
 
 

Q. Do you have evening hours? What about weekends and emergencies? 

 A. Yes, we have evening hours; please call us if you would like to arrange an appointment.  At least two pediatric surgeons from our group are on call and available at all times for emergencies.  
 
  
 
 

Q. What should I tell my child about the surgery? 

 A. This really depends on the age of the child. 

For infants, it's most important that the parents communicate with each other. 

Toddlers are most disturbed by separation.  We try to address the fear of separation by having parents come into the operating room until the child is asleep, and by bringing them to the recovery room while the child is waking up.  Toddlers also are afraid of needles, so we try not to use any until the child is anesthetized. Lastly, they may worry that the surgery is a punishment-so it's important for parents to reassure them. 

School-age children may have fears of anesthesia, experiencing pain, or death. They may benefit from discussion of the procedure or a pre-op visit to the surgical area, and from reassurance. 

Adolescents need the support of their parents just as much as younger children, but they also need to be empowered. They should participate in discussions with their doctors, and be given a voice when decisions are being made. 

  
 
 

 

Q. What if one parent misses the initial consultation? 

 A. The parent who couldn't be at that visit with the doctor should contact the pediatric surgeon, so that he or she has a full opportunity to ask questions, review the issues, and have concerns addressed. The day of surgery is usually not the best time to have a full discussion with the surgeon--parents don't have the opportunity to "digest" the information they are given. 
 

 

 

Q.  Can I go into the OR with my child? 

A.  For most day surgeries, you can.  Parents stay with their child until he or she is asleep, then are brought into the recovery room when the child is waking up.  (Please see our Family Centered Care program for more on this topic.) 

For some surgeries, often emergencies, it's not as safe to have parents in the OR-- your surgeon and your anesthesiologist will explain those special circumstances if they apply to you.