Pediatric Surgery Services

Surgery Specialties

Detailed Surgical Conditions & Interventions

At Alaska Pediatric Specialties, we are able to perform a wide range of services for the children of Alaska. Whether it is a surgery, cancer care, a digestive disorder, heart condition, or recovery from a trauma due to an injury, we can help!

Learn more about the pediatric conditions Alaska Pediatric Specialties can help with by clicking on the links below:

Gastrointestinal & Abdominal

Anal Fissure

An anal fissure is a small tear in the lining of the anus, often causing pain and bleeding during bowel movements. It is common in children and adults, typically resulting from constipation or straining.

Diagnosis is based on symptoms and a physical examination. Initial treatment focuses on softening stools using a high-fiber diet, increased water intake, and stool softeners. Warm sitz baths can relieve pain, while topical anesthetics or nitroglycerin cream may promote healing. Chronic cases may require surgical intervention.

Anorectal Malformation

Anorectal malformation refers to congenital abnormalities where the anus and rectum do not develop properly, often presenting with a lack of an anal opening or abnormal connections to other organs.

Diagnosed shortly after birth through physical examination and imaging studies like X-rays or ultrasounds. Initial management may include creating a temporary colostomy. Definitive surgical correction is typically performed in stages, aiming to reconstruct the anus and restore normal function.

Appendicitis

Appendicitis is a condition where the appendix is infected or inflamed. The appendix is a very small, narrow pouch attached to the intestine. Its purpose is not known. Food and stool can get trapped within this “pouch” and cause it to swell and become inflamed or infected. Occasionally other substances can obstruct this pouch and cause the same result.

The appendix must be removed before it bursts or “perforates” and spreads the infection within the abdomen. An appendectomy is a relatively simple and safe procedure that can be performed laparoscopically.

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Biliary Atresia

When bile does not properly empty from the liver due to a congenital malformation, it is called Biliary Atresia. This rare disorder will appear within two to eight weeks of birth and will be confirmed through a liver biopsy, ultrasound, and nuclear medicine scan. These diagnostic tests will show the alternate path that the bile is taking out the liver. After biliary atresia has been diagnosed, your child’s pediatric surgeon will reconstruct the bile ducts and reattach them to the liver to restore their function and leave the liver.

Choledochal Cysts

Choledochal cysts are rare, abnormal growths in the bile ducts that can cause pain, jaundice, and sometimes infections. These cysts might show up at birth or later in childhood.

Once diagnosed with imaging, your child’s pediatric surgeon will plan to remove the cyst. The surgery not only prevents future infections but also reduces the risk of complications, like liver damage or bile duct cancer. Afterward, your child will be monitored to ensure everything is functioning properly.

Crohn's Disease

Crohn’s disease is an inflammatory condition that affects the digestive tract and can cause belly pain, diarrhea, weight loss, and fatigue. While the exact cause isn’t known, it’s thought to be related to the immune system.



Treatment often includes medications to reduce inflammation and manage symptoms. If symptoms are severe or complications arise, surgery may be needed to remove damaged sections of the intestines. Your child’s care team will work closely with you to create a treatment plan that keeps them feeling their best.

Duodenal Atresia

Duodenal atresia is a condition where the first part of the small intestine (the duodenum) is blocked or not fully developed, which can make it hard for food to pass through. This is usually detected in babies soon after birth.

Surgery is needed to bypass or remove the blockage, allowing food to move properly through the digestive system. With treatment, babies typically recover well and can go on to eat and grow normally.

Gallbladder Infection

The gallbladder is a very tiny pouch that sits just beneath the liver and is responsible for storing bile that is produced by the liver. An infection of this pouch can be either viral or some other cause, such as hypothyroidism. Gallstones, cholecystitis, cancer, and gallstone pancreatitis are common causes of gallbladder conditions that may require surgical intervention. Depending on the severity of the infection, it may require removing the gallbladder altogether.

Gallbladder disease encompasses a range of conditions that affect the gallbladder, including inflammation, infection, and the formation of gallstones. Gallstones are the most common cause, forming when substances in bile crystallize. These stones can block the flow of bile, leading to pain, nausea, and sometimes infection. Other conditions, such as biliary dyskinesia or gallbladder polyps, can also contribute to gallbladder dysfunction. While some cases can be managed with medication or lifestyle changes, others may require surgical removal of the gallbladder to prevent further complications. Early diagnosis and treatment are crucial to managing gallbladder disease effectively.

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Gastroesophageal Reflux

Gastroesophageal reflux disease (GERD), more commonly referred to as acid reflux, is a condition in which food and stomach acid travel back up the esophagus, causing extreme discomfort and damaging the food pathways. To prevent worsening of the condition and cancers of the throat and esophagus, it can be treated by tightening the sphincter of the esophagus or placing a magnetic sphincter.

Gastrointestinal Foreign Bodies and Bezoars

Kids love to explore the world, sometimes by swallowing things they shouldn’t. Foreign objects like coins, toys, or even hair can get stuck in the digestive system, while bezoars are clumps of indigestible materials like hair or fiber that form in the stomach. Depending on the size and location, these can cause pain, nausea, or even blockages.

If an object doesn’t pass on its own, your child’s doctor may recommend imaging to locate it and, in some cases, a procedure to remove it. Minimally invasive tools like endoscopes are often used to safely retrieve the object. Prompt care helps prevent complications, so if you think your child has swallowed something they shouldn’t, don’t hesitate to call for help!

Gastroschisis Repair

Gastroschisis is a problem that happens in newborns and is usually diagnosed prior to birth. It happens when the body structures that are supposed to hold the bowel (intestines) inside the abdomen (belly) do not form correctly. Normally, the body wall and a membrane enclose the bowel inside the abdomen. With gastroschisis, all or part of the bowel develops outside of the baby’s body instead. Other organs may be affected as well. There is no membrane covering to protect these organs. So, they’re more likely to become damaged or infected. Gastroschisis must be repaired with surgery very shortly after your baby is born.

For more information, read here.

Hirschsprung’s Disease

Hirschsprung’s disease is a congenital condition that occurs when nerves do not form in certain parts of the large intestine. This prevents a child from being able to have a bowel movement. Treatment requires a pediatric surgeon to remove the section of the colon that is enlarged and non-functional.

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Malrotation

Malrotation is a condition where the intestines don’t develop in the correct position during pregnancy. This can sometimes twist the intestines (called volvulus), leading to a blockage or cutting off blood supply, which is a medical emergency.

Treatment usually involves surgery to untwist the intestines and place them in a more stable position. Most children recover well with prompt treatment, and the surgery helps prevent future issues. If your child has belly pain, vomiting, or signs of a blockage, it’s important to seek care immediately.

Necrotizing Enterocolitis

Necrotizing enterocolitis is a condition that is most commonly found in premature or unwell newborn babies. It is a gastrointestinal disease that has been caused by some sort of infection or inflammation, which destroys a portion or all of the bowel, causing a portion of the intestine to die. Treatment requires surgical removal of the diseased area of the intestines.

Pyloric Stenosis

Pyloric stenosis is a condition where the opening between the stomach and small intestine is too narrow for it to function, blocking digested food from leaving the stomach. Treatment includes surgery to make the opening bigger, allowing food to pass through unimpeded.

Pyloromyotomy

Pyloromyotomy is a surgical procedure to treat pyloric stenosis, a condition where the muscle at the bottom of the stomach thickens and blocks food from passing into the intestines. This often causes babies to vomit forcefully, appear hungry, and lose weight.

The procedure involves gently cutting the thickened muscle to open the passage, allowing food to flow normally. It’s a quick and highly effective surgery with minimal recovery time. Afterward, your baby can resume feeding and quickly start gaining weight again.

Short Bowel Syndrome

Short bowel syndrome happens when a significant portion of the intestines is missing or not functioning, making it hard for the body to absorb nutrients. This can happen from birth or after surgery to remove damaged intestines.

Treatment is highly individualized and may include special diets, nutrition through IVs, or medications to help with absorption. Some children may need additional surgeries or intestinal transplants. With a dedicated care team, many children thrive and lead active, happy lives.

Thoracic & Chest Wall

Congenital Diaphragmatic Hernia (CDH) - Prenatal

Congenital diaphragmatic hernia - prenatal happens when a baby’s diaphragm doesn’t form properly in the womb, allowing abdominal organs to move into the chest and affect lung development. CDH is usually detected during prenatal ultrasounds.

Prenatal care for CDH includes monitoring your baby’s growth and planning for specialized treatment after delivery. In some cases, fetal surgery may be considered to help the lungs develop. With a skilled care team and early intervention, many babies with CDH do very well.

Pectus Excavatum Correction

Pectus excavatum, also called a sunken chest, is a depression in the chest. The depression may be in the center of the chest or more pronounced on one side (asymmetrical). You may also hear the terms “cup,” “saucer-shaped,” “horns of steer,” or “elongated” used to describe this condition. A child can be born with pectus excavatum or develop their pectus excavatum during their pubertal growth spurt. The pectus excavatum may become more severe with growth spurts. The ribs may flare out as well.

Not all cases of pectus excavatum require surgical intervention. If your child does require surgical correction, your pediatric surgeon will evaluate your child and create a plan. If your child is young and the bones are still pliable, a single surgery can be successful. Depending on the severity of the depression and the age of the child, it will influence the procedural plan. At Alaska Pediatric Specialists, we will develop a surgical plan with you based on your child’s unique needs. For more information, read here.

Pectus Carinatum

Pectus carinatum is characterized by a protrusion of the sternum that occurs as a result of an abnormal and unequal growth of the costal cartilage connecting the ribs to the sternum. Rather than growing flat along the chest wall, the costal cartilages grow outward pushing the sternum forward, giving it a bird like appearance. Another name for pectus carinatum is ‘pigeon chest’. It is a cartilage problem not a bone problem. There can be asymmetry of the chest with one side more prominent than the other. Pectus carinatum is reported to occur less commonly than pectus excavatum.

The cause of pectus carinatum is not known. This deformity occurs in approximately 1 out of 1500 children, often runs in families, and is seen more commonly in males than females. The deformity presents later in childhood than pectus excavatum and becomes more severe as the child grows. Some children with pectus carinatum report that they have chest pain and shortness of breath or limited stamina with exercise. Some children can develop scoliosis. Some children develop self esteem issues related to the appearance. Other children have no symptoms.

Head & Neck / Airway

Thyroidectomy or Parathyroidectomy

The thyroid is responsible for vital bodily functions, including metabolism, breathing and heart rate, body temperature, and more. Conditions that impact the thyroid include Hashimoto’s thyroiditis, graves disease, hyper or hypo functioning, and cancer. Hyperthyroidism or thyroid cancer is both rare in children but may require surgical removal of part or all of the thyroid gland if they are identified. The procedure to remove the thyroid is called a thyroidectomy.

The parathyroid is comprised of four smaller glands located on the thyroid gland and controls the body’s calcium levels. Calcium levels directly impact heart, kidney, and nervous system functioning, among other roles. Hyperactivity or cancer of one or more of the parathyroid glands may require surgical intervention.

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Esophageal Atresia and Tracheoesophageal Fistula

Esophageal atresia and tracheoesophageal fistula are terms that are used to describe abnormal pathways within the trachea or esophagus. These conditions are caused by the esophagus (food tube) or trachea (air tube) not forming properly during a baby’s intrauterine development. These conditions require surgical intervention to prevent food from entering the lungs. A pediatric surgeon will close each of the tubes and reconnect them to the correct organs not long after the baby is born.

Button Battery Ingestion

Kids are naturally curious, and sometimes they swallow things they shouldn’t. Button batteries are especially dangerous because they can cause severe damage to the esophagus or stomach if not removed quickly.

If you suspect your child has swallowed a button battery, it’s an emergency. A pediatric surgeon will need to remove the battery as soon as possible, often using a minimally invasive procedure. Once it’s out the care team will assess any damage and provide the necessary follow-up care. Acting fast can make all the difference!

Urological & Reproductive

Imperforate Anus

Imperforate anus is a failure of the anal opening to form correctly during fetal development. Children born with imperforate anus will not have an anal opening or may have what appears to be a small opening near where the anus should be. During a short time during embryo development, the ends of the gastrointestinal and genitourinary tracts share a common opening called a cloaca. Failure of these structures to separate completely leads to a variety of conditions known as anorectal malformations, which includes imperforate anus.

Congenital Diaphragmatic Hernia (CDH)

Congenital diaphragmatic hernia is a condition where a baby’s diaphragm doesn’t form correctly during pregnancy, allowing abdominal organs to push into the chest cavity. This can affect the development of the lungs and cause breathing difficulties at birth.



Treatment typically begins immediately after birth, with a team of specialists helping your baby breathe and stabilize. Surgery is then performed to repair the diaphragm and move the organs back where they belong. While CDH can be serious, many children go on to lead healthy lives with the right care.

Congenital Diaphragmatic Hernia (CDH) - Prenatal

Congenital diaphragmatic hernia - prenatal happens when a baby’s diaphragm doesn’t form properly in the womb, allowing abdominal organs to move into the chest and affect lung development. CDH is usually detected during prenatal ultrasounds.



Prenatal care for CDH includes monitoring your baby’s growth and planning for specialized treatment after delivery. In some cases, fetal surgery may be considered to help the lungs develop. With a skilled care team and early intervention, many babies with CDH do very well.

Hernia Repair

A hernia is when tissue or bowel finds its way through gaps in the muscles of the abdomen or groin. A hernia can often be observed as a bump or a bulge under the skin where it exists. Hernias do not spontaneously resolve on their own and require surgical intervention to prevent damage to the intestine and allow for pain-free movement of the muscles affected. The major concern with any hernia is that the organs that pass through the wall may become incarcerated, or strangled.



Learn more about the different kinds of hernia repairs:

As kids grow up and enter adulthood, risks of hernias, like incarceration, increase. Childhood hernias can be safely repaired using outpatient (same day) surgery. Best of all, most children recover quickly with only minor discomfort compared to older patients.

For more information about pediatric hernia repair, read here.

Omphalocele

Omphalocele is a condition where some of a baby’s abdominal organs develop outside the body and are covered by a thin sac. This is detected during pregnancy with ultrasounds and requires a planned delivery for specialized care.



After birth, the exposed organs are carefully protected, and surgery is performed to place them back inside the belly and close the opening. Depending on the size of the omphalocele, this may be done in stages. With the right care, many children grow up healthy and strong.

Pediatric Ovary/Ovarian Cyst Removal

The surgical removal of one or both of the ovaries is referred to as an Oophorectomy. The ovaries are the female reproductive organs that contain egg cells and regulate the menstrual cycle. Although this procedure can be done alone, it is often combined with hysterectomy. Removal of the ovaries as well as the fallopian tubes is referred to as a Salpingo-oophorectomy.

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Pediatric Testicular Surgery

There are instances where pediatric testicular surgery may be necessary. The testicles are the male reproductive organs that produce testosterone and sperm. Alaska Pediatric Specialists provides two testicular surgery methods.

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Rectal Prolapse

Rectal prolapse happens when part of the rectum slips out of place and sticks out through the anus. This can occur in children with constipation, straining, or other conditions that weaken the pelvic muscles.

Treatment focuses on addressing the underlying cause, like improving diet to ease constipation or using medications. If the prolapse doesn’t improve or keeps happening, surgery may be recommended to fix the issue and prevent discomfort or complications.

Reproductive Disorders

There are a variety of reproductive disorders that may be present in children that require surgical intervention to correct. Some anomalies are apparent before or just after birth, while some may not present until later in life. A few conditions that are corrected by a team of skilled pediatric surgeons include bladder exstrophy, an external bladder; cloacal anomalies, the rectum, vagina, and urethra joining into one exit; and hypospadias/epispadias, the absence, mislocation, or obstructed urethra. Conditions that may require surgical intervention based on symptoms and severity of condition include vaginal agenesis, the absence of a uterus; obstructed hemivagina with ipsilateral renal agenesis, two independent uteri; and mixed gonadal dysgenesis, the presence of both or ambiguous sex organs, which may require removal of one or both of the gonads. If your child presents with any of these disorders, the team at Alaska Pediatric Specialists can discuss surgical treatment options with you.

Oncology

Cancer

There are many forms of cancer that can afflict children and that be treated or require surgical intervention. Hepatoblastoma is cancer of the liver that is treated by surgically removing the cancerous part of the liver. Neuroblastoma is a rare form of childhood cancer that typically begins near the adrenal glands, and is treated by surgically removing the cancerous cells. Other childhood cancers can be treated by surgically removing the cancerous tissue, always discuss treatment options with your oncologist and pediatric surgeon.

Trauma & Vascular Access

Burns

Burns can happen to anyone, but when they occur in children, they require special care. Burns can range from minor to severe and may be caused by heat, chemicals, electricity, or even friction.

Treatment will depend on the depth and size of the burn. Minor burns can often be treated at home with cool water and clean bandages, but more serious burns might need professional care. A pediatric surgeon may need to clean and dress the wound, and in some cases, surgery might be needed to repair or graft the damaged skin. Our goal is always to minimize pain and help your child heal as quickly and comfortably as possible.

External Catheter and Port Placement and Removal

For children who require frequent intravenous infusions of medication, blood products, or nutrition, or require frequent blood sampling, a long-term intravenous catheter may be recommended. The benefit of a long-term catheter is that they reduce the number of needle sticks the child receives and reduces the risk of infection and vein damage when caustic medications such as chemotherapy or antibiotics are administered. There are two types of long-term central venous catheters, or central lines, that may be used: an external catheter (Broviac® or Hickamn®) or a totally implanted catheter, port, (Portacath® or Mediport®).



An external catheter leaves a tube that hangs out of the placement incision in the skin. An internal port is implanted under the skin and is accessed with a special needle as needed. Both types of central lines are placed by a pediatric surgeon in the operating room and can be removed in an outpatient procedure.

Disclaimer

All content found on this Site was created for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it based upon information you may have read on this Site.

If you think you may have a medical emergency, call your doctor, go to the emergency department, or call 911 immediately.