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Until now, babies born in a hospital in Pomerania in Szczecin, diagnosed with congenital hernia and other conditions requiring surgical intervention, had to be operated on in other centers. Now newborns will receive help on the spot - surgical operations will be carried out at the SPSK-2 Neonatal Pathology Clinic, without the need for transport to another hospital. The first hernia operation has already taken place and the little patient is fine and is at home.
At the Independent Public Clinical Hospital No. 2 PUM in Szczecin, approximately 2,200 children are born annually, but newborns diagnosed with hernia had to be transported to the hospital at Unii Lubelskiej for surgery. Now that will change.
- We wanted the surgical operations of our little patients to take place in our neonatal unit, so as not to 'tear' them out of their environment in which they are treated and not to transport them to other hospitals - explains Dr. n. med. Beata Łoniewska, prof. PUM, the doctor in charge of the SPSK-2 Department of Newborn Pathology.
Such a change of treatment place and transport are important for the newborn, especially for the premature baby - it is also about the fact that the child does not have to go to other pediatric wards with older children after the surgery.
Thanks to the cooperation with pediatric surgeons from the Independent Public Clinical Hospital No. 1 PUM im. Prof. T. Sokołowski, the first bilateral inguinal hernia in a premature infant was performed this time in the Department of Newborn Pathology of the Independent Public Teaching Hospital No. 2 PUM in Szczecin.
The patient was a premature baby born in the 27th week of pregnancy with a birth weight of 780 g. The operation took place on the 50th day of his life and was performed by Justyna Rajewska-Majchrzak, MD, PhD and MD. Karolina Rosołowicz from the Department of Pediatric Surgery, Oncology, Urology and Hand Surgery SPSK-1 together with the team of nurses and midwives SPSK-2.
Anesthetic was a big challenge. Dr hab. n. med. Maciej Żukowski, prof. PUM, a specialist anaesthesiologist from a hospital in Pomorzany, used the so-called regional anesthesia - directly to the sacrum, because in such a small patient it is difficult to precisely find the space between the vertebrae, where it is normally administeredanesthesia.
In addition, the anaesthesiologist decided not to intubate a child who, due to his prematurity, had severe bronchopulmonary dysplasia, and thus a risk of respiratory complications.
The operation lasted about 2 hours and went smoothly, and the little patient returned home in good condition.
Cooperation with specialists from SPSK-1 has been going on for years - doctors from the Union of Lublin consult small SPSK-2 patients with surgical problems. Now the treatments will be performed on site, in a hospital in Pomorzany.
The Department of Neonatal Pathology also performs procedures of closing arterial ducts in newborns and surgical treatment of premature retinopathy.
Inguinal hernia
An inguinal hernia is an abnormal bulge in the groin. Congenital inguinal hernia is a common condition in premature babies (it is diagnosed in about 4% of newborns). In premature babies, the risk of its occurrence is higher, the lower the birth weight of the baby is. The operation is then necessary.
Inguinal hernia is found 3-10 times more often in boys than in girls. The symptom is a soft lump above the groin that gets bigger when the baby cries, screams or coughs, and when the pressure in the abdomen increases. The bulge recedes as the baby calms down.
The most dangerous complication of an inguinal hernia is its entrapment. The result may be intestinal obstruction due to compression and ischemia, and long-term ischemia of the incapacitated bowel loop may lead to necrosis and the development of a generalized infection. In the event of a hernia entrapment, the intervention of a pediatric surgeon is required.