Surgery

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How to prepare your child for surgery

April 24, 2013

Surgery can be a stress and anxiety producing event for anyone, let alone a child. At Swedish, Child Life Specialists help children and families cope with the surgery process. Child Life Specialists are available to help educate and prepare children and families prior to surgery in our outpatient surgery center.

There are some things you can do as a parent to help better prepare yourself and your child for surgery before coming to the hospital:

  • Talk to your healthcare provider to educate yourself about the surgery process and what to expect.
  • Talk to your child in advance about their surgery in an honest, matter-of-fact manner. Younger children need to start hearing about their upcoming surgery 2-3 days prior to their visit. School age and teenage children can handle talking about their surgery a few weeks in advance. Using books and similar resources can be helpful in talking to your child about their surgery.
  • Offer children some control wherever possibl...

What should you know about pain killers after surgery?

April 17, 2013

Recovering from major surgery is an active process that typically takes 6 weeks. Surgical pain is normal and expected, but the pain experience may be different for individuals. Since pain can interfere with your ability to participate in activities to prevent complications (coughing, deep breathing, walking), treating pain is critically important for a successful surgical recovery. Many patients are afraid to take prescription narcotics or “pain killers” because they do not want to become “addicted.” However, untreated pain can lead to the development of permanent pain pathways to the brain, which can delay your recovery and possibly even result in chronic pain.

Narcotic use varies among individuals and there is a big difference between drug dependence and addiction. Dependence is when the body has become accustomed to the medication. This can occur anywhere from a couple of days to a couple of weeks after you start taking pain killers regularly, like after...

Is Robotic Surgery Right For You?

April 14, 2013

In recent years, there has been a surge in the popularity of robotic surgery. This is an exciting new technology that is being actively used by many specialists here at Swedish. In General Surgery, we have been using a minimally invasive approach called laparoscopy for many years. This allows us to use smaller incisions, giving the patient much less pain and a quicker recovery.  Robotic surgery is very similar.

Here are the answers to some frequently asked questions about robotic surgery:

Are incisions smaller with robotic surgery than with laparoscopy?

No. The incisions are pretty much the same. As a patient, you might not be able to tell much of a difference from the surface.

Do the robotic instruments allow the surgeon to perform a better operation?

When a belly ache or stomach pain might mean appendicitis

February 28, 2013

As a pediatric surgeon, I am often asked when to “worry” about abdominal pain. Children often report aches or pains near the belly button (umbilicus), and the question arises around when this might mean something significant such as appendicitis.

Appendicitis is a common occurrence affecting about 7% of people over their lifetime, and it begins with vague abdominal pain of the central abdomen. Once the appendix becomes obstructed and begins to suffer from lack of circulation (ischemia), the body can detect more accurately the exact source of the pain. After this localization occurs, children older than 6 or so can identify that the pain is most severe in the right lower part of the abdomen. The localization usually occurs within 24 hours of feeling unwell. The pain is typically worse with movement of the appendix during activities such as walking, coughing, and change in position. I often ask children to jump up and down (on their bed is something kids are excited to do!) and watch ...

Activity after open or laparoscopic abdominal surgery

February 06, 2013

Activity after SurgeryEvery patient who visits my office with a surgical condition has several decisions to make and has a lot of information to absorb and understand.

I typically spend much of our time together describing the condition itself, why I recommend surgery, how I will perform the surgery and any risks involved in the procedure. While this is all critical to anyone’s understanding of their treatment plan, once the decision has been made to proceed with surgery, many patients’ concerns quickly turn to their recovery and what to expect after surgery. Most patients want to know when they can get back to walking, lifting, exercising, and their normal daily routine. While every patient and procedure is different, some generalizations can be made to help you know what to expect.

General abdominal surgery can broadly be separated into two categories: 1) open surgery where a large...

The Goal of DBS (Deep Brain Stimulation) Surgery

February 01, 2013

I met with several patients this week to discuss their personal journey to making the decision to pursue DBS surgery. Not surprisingly, they were well educated about their disease and treatment options.

Each patient reminded me that there is a lot of information and misinformation about surgery for movement disorders.

The most important advice I can give any patient or family is...

Why you should have your hernia repaired

December 31, 2012

Do you have a groin bulge that seems to come and go, often absent upon waking in the morning? Or perhaps you already know you have a hernia? Hernias are very common and occur in approximately 1 in 4 males (less common in women), so chances are you or someone you know has or has had an inguinal hernia. The main question I always get asked is "should it be fixed?"  

As a general surgeon, I see 4-5 patients every week with a newly diagnosed inguinal hernia. Many are self-referred after discovering a lump in the groin, while many others are referred from their primary care provider after the hernia is discovered during the physical exam. After verifying that a hernia is the correct diagnosis (other possibilities are a groin strain, swollen lymph node, etc.), I have a discussion which addresses the aforementioned question. As an aside, these are very common and also found in the pediatric population (

Hernias: why are some watched while others are repaired?

September 17, 2012

The most common thing that I see as a pediatric surgeon is a child with a lump that is thought to be a hernia. A hernia is a bulging of tissue through an opening in the muscle layers that isn’t normally present. In children, these openings are usually the result of a developmental process that just didn’t quite reach completion. Some hernias need surgery emergently, while others are observed for years with the expectation that they will close on their own.

Here are some pointers to help understand this wide range of approaches to hernias:

Location is very important in considering how aggressive to be with hernias. Belly button (umbilical) hernias are...

Rib Fractures: Essentials of Management and Treatment Options

August 22, 2012

Rib fractures are the most common chest injury accounting for 10 to 15 percent of all traumatic injuries in the U.S. Nearly 300,000 people are seen each year for rib fractures and 7 percent of this population will require hospitalization for medical, pain, and/ or surgical management.

Rib fractures can cause serious complications including: bleeding in the chest (hemothorax), collapse of the lung (pneumothorax), or result in a fluid accumulation in the chest (pleural effusion), just to name a few. As well, rib fractures may contribute to the development of a lung infection or pneumonia. These problems are important to diagnose following chest trauma and even more importantly, when present, they need to be followed closely in the early post-traumatic period.

The most common symptom that people experience with rib fractures is....

Fixing Chest Wall Deformities: A Minimally Invasive Option

July 25, 2012

Pectus excavatum often referred to as either "sunken" or "funnel" chest is the most common congenital chest wall deformity affecting up to one in a thousand children. It results from excessive growth of the cartilage between the ribs and the breast bone (sternum) leading to a sunken (concave) appearance of the chest.

Although present at birth, this usually becomes much more obvious after a child undergoes a growth spurt in their early teens...