It all started in the middle of
the 19th century as the surgical care of birth defects required novel
techniques and methods and became more commonly based at
children's hospitals. One of the sites of this innovation was Children's
Hospital of Philadelphia. Beginning in the 1940s under the surgical leadership
of C. Everett Koop, newer techniques of endotracheal anesthesia of infants
allowed surgical repair of previously untreatable birth defects. By the late
1970s, the infant death rate from several major congenital malformation
syndromes had been reduced to near zero.
Nearly 100 years ago, William Ladd,
MD, of Boston Children’s Hospital, helped establish pediatric surgery as a
medical subspecialty. The recognition that children require unique surgical
management hasn’t changed, but the instruments and procedures we use to operate
on children have evolved dramatically. Here’s a glimpse of the surgical state
of the art then and now.
Then
The
1920s marked the earliest use of scrub attire. White gowns, white masks and
white linens emphasized the importance of cleanliness — and perhaps compensated
for the dim lighting. Chloroform and ether, dating back before the Civil War,
were the anesthetics of the day. Though penicillin was discovered in 1928,
antibiotics were still two decades away from actual use. Imaging was limited to
X-rays. It was in this setting that pediatric surgery began to evolve.
Today
In the XXI century we
find Pediatric Surgery at another level. Keeping it at the same level and
performance as Adults General Surgery nowdays pediatric surgeons perform
surgeries using most advanced techniques. Stepping over the boundaries, we find
pediatric surgeons using surgical robots and state of the art technologies in
their surgical techniques.
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