KING EDWARD MEMORIAL HOSPITAL

Sections Units Branches

Staff

FACULTY:

Name	Designation		Date of Joining		MMC Registration
			As faculty	As current designation
Dr. Sandesh V. Parelkar	Professor and Head ( Teacher )		09-12-2004	08-12-2005	61788
Dr. Beejal V. Sanghvi	Professor ( Teacher )		24-12-2003	24-12-2012	83987
Dr. Rahulkumar Gupta	Additional  Professor ( Teacher )		08-12-2008	28-11-2017	3845
Dr. Kedar P. Mudkhedkar	Additional Professor ( Teacher )		20-08-2015	19-09-2017	1191
Dr. Deepa Makhija	Assistant Professor ( Teacher )		13-3-2018	13-3-2018	2009/05/2303
Dr. Rujuta Shah	Assistant Professor ( Teacher )		23-3-2018	23-3-2018	2008/04/1655

Postgraduate students :

Senior Registrar

Dr. Manish Kumar Kashyap

Dr.  Nehal Shah

Senior Residents

Dr Mahendra Dandge      SR III

Dr Sonal Malviya               SR III

Facilities, Equipments & Special services

SERVICES PROVIDED

The department of Paediatric Surgery has a ward with a capacity of 50 beds – including an eight-bed intensive care unit and a dedicated operation theatre complex with an endoscopy room. The department deals with a wide spectrum of cases below the age of twelve years.

Both emergency and elective cases are seen; the referrals being from private practitioners, school health clinics, outpatient clinics, peripheral primary and secondary health care centres and from the Departments of Paediatrics and Neonatology. Regional patients form neighbouring states are also treated in the department.

The department provides emergency services daily with residents  available on the floor round the clock. The department runs out patient clinics twice a week on Tuesday and Thursday at 1:30pm in OPD 11 on the ground floor Multistory Building. Every Thursday at 2.30 pm, a speciality multi-disciplinary Birth defect Clinic has been started , where couples with antenatal scan showing anomalies are jointly counseled.

The department runs two operation theatres five days a week. The total surgeries performed annually are about 2000; 800 of which are major operations. Routine upper G. I. Endoscopies, bronchoscopies and cystoscopies are done regularly.

MIS: 3286 total. Recently 4K laparoscopy system has been acquired also.

Add below it Laser as new point 8: Holmium Laser for laser treatment of posterior urethral valves, bladder and ureteric calculi, stricture urethra. More than 100 laser procedures done

Others, current activities. Diaphragmatic hernia-age from newborn to 13 years, including newborns on ventilators

Patient Care

Education: daily counselling of all ICU patients relatives, detailed counselling to admitted patients, detailed education about disease awith emphasis on treatment and follow up for all chronic conditions like posterior urethral valves, VUR, BOO, neurogenic bladder, anorectal malformations, esophageal atresia, diaphragmatic hernia, etc

MSW

Anjeze trust: weekly counsel patient regarding hygiene

Division of Paediatric Surgery covers a wide area of work namely :

1. General Paediatric Surgery
   This includes problems such as hernias, uro-genital lesions, lumps and bumps, head and neck lesions, haemangioma, lymphangioma, cystic hygroma and perianal conditions.
2. Neonatal Surgery
   Expectant mothers with babies with congenital anomalies are seen together with the obstetrician doing the ultrasound assessments and their management planned. Gastro-intestinal, abdominal wall defects, diaphragmatic hernias, lung cysts and malformations, teratomas (sacroccygeal, mediastinal, pharyngeal and cervical) and renal anomalies are among conditions diagnosed and managed.
3. Urology
   Paediatric urology makes up about 30% of the work of the division. Nephrectomies, nephro-ureterectomies and partial nephrectomies are carried out. Pyeloplasties, hypospadias repair, undescended testis, neurogenic bladder and vesico-ureteric reflux are common urologic conditions seen. A complete set of cystoscopes is available from newborn till adolescent age.
4. Hepato-biliary and Gastrointestinal Surgery
   Biliary atresia and choledochal cyst are common hepato-biliary conditions seen in the division. Liver tumours, though uncommon, are managed together with Paediatric oncologist. Pancreatic illnesses such as acute and chronic pancreatitis and pancreatic tumours are also treated. All small and large bowel atresias, obstructions and intussusceptions are managed. Upper GI endoscopy through flexible OGDscope with retrieval of foreign bodies, esophageal dilatation is also done.
5. Thoracic Surgery
   All extra cardiac thoracic lesions in the neonates are followed up from antenatal diagnosis to post-natal surgery by the division. The commonest of the conditions managed are empyema, lung cyst, cystic adenomatoid malformation of the lungs, pulmonary sequestration and congenital lobar emphysema. Intra thoracic tumours, lung bulae with recurrent pneumothorax, esophageal atresia and fistula are also dealt with.
6. Surgical Oncology
   Wilms’ tumour, neuroblastoma, hepatoblastoma, sacrococcygeal and other teratomas and mediastinal tumours are managed jointly with Medical Paediatric Oncology at Tata Memorial Hospital.
7. Minimally invasive surgeries
   Both diagnostic & therapeutic laparoscopies and thoracoscopies are performed regularly. In ther last 11 years, 1852 laparoscopic and thoracoscopic procedures have been conducted. The department has recently acquired 3 – D laparoscope, a first in MCGM Hospitals.
8. Birth Defect Clinic

Every Thursday at 2.30 pm a speciality Birth defect Clinic is conducted; where all children with any congenital anomaly, pregnant          ladies with antenatal USG showing fetus with congenital anomalies, ladies with bad obstetric history and also couples with family          history of birth defect are seen in the clinic. The specialists   from respective speciality have a joint consultation, outline                            management plan and   counsel the children alongwith their families in this clinic. More than 300 families have attended the                  clinic.The clinic is conducted every Thursday afternoon at 2.30 pm in the Board Room, Department of Paediatric Surgery, 3^rd                 Floor, Old building, Gynecology Wing, K.E.M. Hospital.

9. Sophisticated post-surgical ICU:

The special 8 bedded ICU provides much needed postoperative care to neonates, infants and children who need ventilation                     and/or ICU care. The department possesses a high frequency oscillatory ventilator system for ventilation of newborn children                 with congenital diaphragmatic hernia and pulmonary hypertension and adequate warmers and multipara monitors.

TRAINING FACILITIES

The department runs a superspecialty M. Ch. course in Paediatric Surgery for which post-MS or post-DNB General Surgery candidates are enrolled every year (recognized by Medical Council of India (MCI) and Maharashtra University Of Health sciences[MUHS]). The department undertakes teaching of undergraduate and postgraduate students. A specialised paediatric surgical and general nurses’ training is also undertaken.
The department has a well equipped library with all standard reference books, video cassettes, ebooks and slides. Journal Club is regularly conducted.
The department has an independent seminar hall and conducts regular clinical meetings, which are attended by surgeons from many hospitals in Mumbai.
Research work carried out by the department includes publication and analysis of rare case reports and other articles in international journals.
We have started fellowship in minimal access surgery in pediatric surgery, a 1-year course recognised by MUHS, for 2 candidates per year post M. Ch or DNB in pediatric surgery. Till date, 8 fellows have already been trained; 2 further are undergoing their fellowship.

Other

FUTURE DIRECTIVES

The department of Paediatric surgery at Seth G S Medical College and K. E. M. Hospital over the years has achieved a high degree of sophistication under the ever watchful eyes of Dr. S.V.Parelkar (Professor and Head) and his team. This is mainly based on

• Maturation of techniques of repair
• Refinement of neonatal care in general (Paediatric anaesthesia, Neonatology, Radiology).
• Deeper understanding of neonates physiology and special needs.
• Advances in minimal access surgery

Training of pediatric surgeons in minimal invasive surgery through the MUHS conducted fellowship. Advanced laparoscopic and thoracoscopic surgeries will be aided by latest acquisition of 3 – D Laparoscope.

TOWARDS A MINIMALLY INVASIVE MILLENIUM:

There has been a changing trend in the field of Paediatric surgery with Minimally Invasive Surgery playing a bigger role in the management of surgery of children. Instrumentation is improving and also the skills need to be acquired and augmented to enable safe surgery through a laparoscope in smaller babies, even neonates.

Both thoracic and abdominal ailments are being treated by minimal invasive surgery and a wide range of basic and advanced surgical procedures are being carried out from newboens till 12 years age.

FOETUS AS A PATIENT:

“NEW ERA” of widespread screening of the unborn child by ultrasound (USG) with planned intrauterine, intrapartum and immediate postpartum interventions. With the development of sophisticated ultrasonographic imaging and fetal sampling techniques, a growing number of fetal disorders are amenable to surgical manipulation. This is undertaken at a very few selective centres.

ROBOTIC SURGERY:

With the widespread availability of robotic surgical systems, it is natural for advanced paediatric surgical reconstructive surgeries to be carried out by using such systems. The department plans to procure a robot for all such procedures which will greatly benefit these children.

CURRENT ACTIVITIES:

The department has performed bilateral Laparoscopic cortex sparing adrenelectomy for pheochromocytoma with von-Hippel-Lindau syndrome in 10yr boy.Aim was to save the adrenal cortex and avoid addisonian state in the child .

Laparosocpic management of retrocaval ureter with uretero – ureteric anastomosis. Normally this surgery would need a large vertical midline incision.

Whipples pancreatico duodenonectomy with bilateral adrenelectomy for pancreatric neruro ectodermal tumor with bilateral phaeochromocytoma

Distal splenorenal shunt for portal hypertension.

The department has recently successfully performed a laparoscopic partial splenectomy in a 10 year girl with a benign splenic cyst. clinically a mobile lump in the LHC 10x8cm was palpable. USG and CT were suggestive of a splenic cyst with peripheral calcification arising from the lower pole. Laparoscopy was done under GA in supine position with 4 ports. the lower polar vessels were clipped and a good line of demarcation had formed. We then used the harmonic scalpel to divide the spleen along the line of demarcation and removed the specimen through  a small pfannensteil incision. The histopathology came as epidermoid cyst. Patient had an uneventful recovery.

The department has successfully performed thoracoscopic repairs of congenital diaphragmatic hernia and eventration of diaphragm.The youngest child was 15 days old and the oldest 1.5 years.

“SIMPL” Nephrectomy

We have recently done a retroperitoneoscopic nephrectomy for a non-functioning kidney secondary to pelvi-ureteric obstruction in a six-year-old boy. It was done with the patient in the prone position with only 2 ports – one for the camera and the other for the instrument port. This is a relatively new technique, SIMPL stands for Single Instrument Port Laparoscopy. Thus the entire procedure is done through only one working port and there are only 2 small incisions on the back.

CURRENT TEAM

Sitting: Dr B V Sanghvi, Dr S V Parelkar, Dr R K Gupta, Dr K P Mudkhedkar
Standing: Dr Manish Khobragade, Dr Akhilram, Dr Pooja Tiwari, Dr Saundarya, Dr Rujuta Shah, Dr Kavimozhy, Dr Kamal Sharma, Dr Ashutosh Sharma
Photos of golden jubilee celebrations 16-12-2017

CONTACT

Department of Paediatric Surgery
Seth G.S.Medical College & K.E.M.Hospital, Parel,
Mumbai-400 012, Maharashtra India.
Tel: 0091-22-2413 6051 Ext:2220
Fax:0091-22-2414 3435
Email : websitecontact@kem.edu

Bai Jerbai Wadia Hospital for Children

Department of Pediatric Surgery

Faculty:

Dr. Susmita Bhatnagar-         Professor

Dr. Pradnya Bendre-              Professor

Dr. Suyodhan Reddy-            Additional Professor

Dr. Parag Karkera-                Associate Professor

Dr. Flavia Dsouza-                Assistant Professor

Dr. Gayatri Munghate-         Assistant Professor

Postgraduate students:

Dr. Amol Nage – Post Mch Registrar

Dr. Uttam Rawate – SR II

Dr. Praveen Raju – Jr Reg

Dr. Ajraj Mishra- Jr Reg

Bai Jerbai Wadia Hospital for Children
Department of Pediatric Surgery

Academic courses

MCh in pediatric surgery-3 year superspecialty course

Fellowship in Minimal Access in Pediatric Surgery-1 year MUHS recognised fellowship

Teaching schedule:

Weekly case presentation

Every  Saturday- grand round,

Monthly  journal club

Daily teaching in OT, in OPD and on ward rounds

Resident –presenter is responsible for organization should contact coordinator 1 wk before activity .involved faculty or resident should contact coordinator if they need any adjustment.

Copies of journals to  be emailed to all 1 wk in advance.

Attendance is mandatory to residents.

Faculties are encouraged & appreciated for participation.