General and thoracic surgeons perform procedures on many different parts of the body. They typically focus on treating conditions of the abdomen, skin, soft tissues, breasts, or endocrine (hormone) system. These surgeons often work in emergency and trauma situations, performing common surgeries, such as removing the appendix.
It’s normal for parents, caregivers, and children to feel anxious about surgery. That’s why at Children’s Hospital & Medical Center, our pediatric surgeons and staff are dedicated to addressing your child’s medical issue and seeing them healthy on the other side of recovery.
What Sets Children’s Apart?
We have the only board-certified pediatric surgeons in Nebraska. Board certification requires staying up-to-date on the latest in surgical care. This means your child is receiving the most advanced care possible.
While adults may need general and thoracic surgery too, children aren’t mini adults. Some treatments for adults aren’t appropriate for kids, and medical research done with adults may not apply to children. By focusing solely on pediatrics, our surgeons and staff are experts at assessing the unique treatment needs of children and teenagers. They know how to explain procedures at a child-friendly level and help the child and the entire family feel comfortable going into surgery.
Here are other ways that Children’s is unique:
- Combined, our surgeons bring about 50 years of experience and 30 years of training to the operating room.
- Children’s is the region’s leader in developing and performing new, innovative pediatric minimally invasive surgical procedures. These procedures use tiny cuts, rather than large incisions. They produce minimal scarring, less pain, fewer complications, and a quicker recovery time.
- All of our anesthesiologists are specially trained in meeting the needs of children. In addition to knowing the dose of anesthesia that’s safe for a child, they understand how to communicate with patients who are not yet able to describe pain or symptoms, and how to make children comfortable with the anesthesia process.
Conditions We Treat
General and thoracic surgeons treat a very wide range of conditions. This is partly because many conditions can overlap with ones from other specialties. In fact, it’s not uncommon to see general and thoracic surgeons collaborating with providers from other specialties, such as oncology or gastroenterology.
AchalasiaThe esophagus — the tube that brings food through the throat to the stomach — cannot push food down toward the stomach.
AppendicitisThe appendix — a small organ attached to the large intestine — becomes blocked. This causes problems with blood flow and swelling, causing sudden pain. If left untreated, it can burst and spread infection throughout the abdomen.
Crohn's DiseaseParts of the digestive system become swollen. Symptoms vary depending on the part of the digestive system that’s affected, but main symptoms include belly cramps, fatigue, and diarrhea.
Dermoid CystThis is a non-cancerous tumor that contains a cyst. The cyst is filled with tissues that are usually found in outer layers of the skin, such as oil or sweat glands, or elements of teeth or hair.
EmpyemaPus collects in the pleural space — the space between the inner surface of the chest wall and the lung. It can cause chest pain, dry cough, shortness of breath, fever and chills, or excessive sweating.
GallstonesThe gallbladder is an organ that stores bile, which is a fluid that helps the liver digest fat. When substances in bile harden, they can form stones. These stones may get stuck and block the flow of bile, and this blockage can cause upper abdominal pain.
GastroschisisA birth defect (present at birth) where there is a hole in a baby’s abdominal wall, which causes the intestines to stick out through the outside of the body. If the intestines are damaged, the baby may have trouble absorbing food.
HydroceleA hydrocele is a fluid-filled sac in a newborn infant’s scrotum. It can cause swollen testicles.
Inflammatory Bowel DiseaseThere are two types of inflammatory bowel disease — Crohn’s disease and ulcerative colitis. Both involve long-term swelling in the digestive tract, which can eventually cause damage to the tract.
Inguinal HerniaThis is a hernia — tissue that bulges out of a weak spot in the abdominal wall — in the groin area. An inguinal hernia can cause pain or discomfort in the groin, or an enlarged or swollen testicle in boys.
IntussusceptionOne part of the intestine slides into another part. This can block food from passing through the intestine and cut off blood supply to part of the intestine. A hole can develop, which could lead to dehydration, infection, or shock.
NeuroblastomaThis is a cancer that forms in nerve tissue. It often begins in early childhood, and sometimes before a baby is even born.
OmphaloceleThis is a defect where there is a whole in the abdominal wall, usually causing a child’s intestines to stick out through the hole. If the hole is very large, the liver or organs can stick out, too. Omphaloceles develop before a baby is born.
Pectus ExcavatumThe rib cage doesn’t form correctly while a baby is still developing in the womb. This gives the chest a sunken or caved-in appearance.
Pyloric StenosisThe pylorus is the opening from the stomach into the small intestine. Pyloric stenosis is when the pylorus narrows, which can cause vomiting, abdominal pain, constant hunger, dehydration, or inability to gain or lose weight.
ScoliosisThe spine curves sideways into a “C” or “S” shape, rather that in a straight line. Smaller curves usually aren’t noticeable until a child is older, generally during puberty. Scoliosis can cause tilted and uneven shoulders, an uneven waistline, or one hip being higher than the other.
Ulcerative ColitisThis is a condition where ulcers (sores) and swelling develop in the lining of the rectum and colon. Symptoms usually include pain in the abdomen, and blood and pus in diarrhea.
Umbilical HerniaAn umbilical hernia occurs when there is a bulge in the lining of the abdomen or part of the abdominal organs, right around the belly button. It happens when the muscle that the umbilical cord passes through doesn’t completely close after birth.
Surgeries We Perform
General and thoracic surgery at Children’s is performed in four different clinics: bariatric, colorectal, thyroid and endocrine, and short gut/short bowel syndrome.
Bariatric SurgeryBariatric surgery a procedure that is performed on teenagers who have participated in our Weight and Wellness program, and have not been able to lose weight despite diet and exercise changes.
Bariatric surgery reduces the size of the stomach. This limits how much your teen can eat, and how many nutrients their body can absorb. It is a very effective procedure — the average teen loses about 90 pounds after surgery. They also see improvements in obesity-related conditions they may have had before surgery, such as diabetes or high blood pressure.
Even though bariatric surgery is effective, it is not a cure by itself. Your teen will need to lead a healthy lifestyle by staying physically active and eating a nutritious diet.
Colorectal SurgeryColorectal surgery focuses on the colon and the rectum. The colon is the longest part of the large intestine. It is a tube at the end of the digestive tract where the body makes and stores stool. When the colon is full, the stool is passed to the rectum — the end of the large intestine that is closest to the anus and holds stool until it is ready to leave the body.
Short Gut Syndrome/Short Bowel SurgeryChildren need fully-functioning intestines in order to absorb the nutrients they need for growth. Diseases, such as gastroschisis and necrotizing enterocolitis, can lead to short bowel syndrome (also called short gut syndrome), which is a condition where the small intestine has trouble absorbing nutrients.
If your child has short bowel syndrome, they may need a serial transverse enteroplasty (STEP). STEP is a procedure to lengthen the small bowel, allowing more room to absorb nutrients.
Thyroid And Endocrine SurgeryThe endocrine system is a network of eight glands that make hormones. Hormones travel through the bloodstream to the tissues and organs that are responsible for telling body parts how to form and function. These hormones control growth, development, reproduction, sexual function, mood, and metabolism (how the body converts food and drink to energy). If your child’s body makes too much or too little of a hormone, they may have an endocrine disorder.
Our surgeons can perform surgery for several different endocrine conditions, but the vast majority of our patients have problems with their thyroid — the gland in the neck that produces the hormone that controls metabolism. This hormone helps the body use energy to keep the heart, muscles, brains, and other organs functioning correctly.
In addition to thyroid problems, we also perform surgery for multiple endocrine neoplasia (MEN) syndromes. These are rare disorders in which either cancerous or noncancerous tumors — masses of cells that lump together — develop on several endocrine glands. MEN can also occur if several endocrine glands grow excessively without forming any tumors.
The procedures we perform most often include:
- Fine needle aspiration (FNA) biopsy: We use a very thin needle attached to a syringe to take a sample of tissue from your child’s thyroid. The sample is then examined under a microscope to look for signs of cancer.
- Thyroidectomy: We remove the entire thyroid (total thyroidectomy) or part of the thyroid (partial thyroidectomy). This may be recommended if your child has thyroid cancer or a noncancerous tumor that is causing symptoms. After a total thyroidectomy, your child will probably need to take thyroid hormone replacement pills for the rest of their life.
- Parathyroidectomy: The parathyroid glands are just below the thyroid, and they help control calcium levels in the blood. Your child may need one or more of these glands removed if they are causing hyperparathyroidism — producing too much parathyroid hormone, causing symptoms such as bone pain, nausea, or kidney stones.
- Neck dissection: This procedure involves removing lymph nodes — small structures filled with immune cells that fight infection by destroying germs in lymph fluid. Your child may need neck dissection if they have cancer that has spread to the lymph nodes.
- Adrenalectomy: The adrenal glands are located on top of the kidneys, and produce steroid hormones (e.g., cortisol), hormones that can be changed into testosterone, adrenaline, and noradrenaline. Your child may need one or both adrenal glands removed if there is a lump that is cancerous, looks like it could be cancerous, or is causing harmful side effects (e.g., high blood pressure).
What To Do Next
Make An Appointment
Your child will need a referral for surgery. Once you have received the referral, make an appointment with a general and thoracic physician. Call 402-955-7400.
For Referring Providers
The Physicians’ Priority Line is your 24-hour link to pediatric specialists at Children’s for referrals, emergency and urgent consults, physician-to-physician consults, admissions, and transport services. Call 855-850-KIDS (5437).
Learn more about referring patients.