Department of Neonatal Surgery

FOCUS AREA

• Health care for the babies with congenital anomalies
• Genetic counseling
• Birth support
• Surgical treatment of newborns with the use of minimally invasive endoscopy
• Intensive therapy and postoperative care

SERVICES

• Prenatal diagnostics of congenital malformations;
• Management of pregnant women with malformations in their fetuses in one of the Departments of the Center depending on the specificity of fetal malformation and subsequent delivery;
• Laboratory and instrumental examination of a newborn "on site";
• Emergent surgery to correct congenital malformations;
• Neonatological care considering the severity of malformations;
• Emergent cardiac care

EMERGENCY SURGERY

Emergent surgery after short preoperative preparation and stabilization of the patient’s state:

• embryonic hernia (omphalocele);
• gastroschisis;
• esophageal atresia;
• congenital intestinal obstruction;
• congenital diaphragmatic hernia;
• cystic malformation of the lung with symptoms of respiratory failure;
• complicated tumors and masses  of any location (e.g. ovarioan torsion or rupture)

DELAYED SURGERY

The diseases requesting delayed surgical treatment after the use of additional methods of diagnostics:

• abdominal masses;
• multicystic kidney disease;
• megaureter;
• hydronephrosis;
• billary atresia;
• bulky formations of various localization (teratomas, lymphangiomas, etc.);
• lung adenomatosis;
• lung sequestration

CESAREAN SECTION

Fetal pathology requesting cesarean section:

• large teratomas;
• large embryonic hernias;
• large lymphangiomas;
• gastroschisis

TECHNIQUES AND TECHNOLOGIES

In neonatal surgery:

• endoscopic correction of  congenital malformations and surgical diseases in the newborns;
• side-to-side/end-to-side anastomosis for congenital anomalies and the diseases of digestive system;
• plastic surgery of diaphragm defects and thoracoscopy with the use of synthetic materials for congenital diaphragmatic hernias in newborns;
• anterior abdominal wall plasty in newborns with gastroschisis and omphalocele;
• lobectomy;
• nephrectomy, ureter neoimplantation;
• heminephrureterectomy;
• endoscopic bougienage and stenting of the ureteral orifice;
• bladder plastic surgery with local tissues;
• uretero-ileo-sigmoidostomy;
• laparoscopic nephroureterectomy

In pediatric cardiology:

-  one-step correction of surgical and cardiosurgical pathology in the newborns with concomitant pathologies;

- resection of critical coarctation of the aorta;

- clipping of patent ductus arteriosus in patients with extremely low and very low body weight

In neonatal anesthesiology and resuscitation:

• individual selection of fluid, cardiotonic, vasotropic and respiratory therapy, Doppler blood flow assessment, MRI and CT, immunological and neonatal molecular genetic testing for malformations in the perioperative period;
• extracorporeal membrane oxygenation in newborns with critical respiratory failure in the preoperative  and postoperative period;
• peritoneal dialysis, hemodialysis, ultrafiltration in newborns with acute renal failure;
• high-frequency oscillatory mechanical ventilation intraoperatively in infants with severe respiratory failure;
• targeted therapy of pulmonary arterial hypertension in newborns with the use of inhalation of nitric oxide (II) and prostacyclins,  phosphodiesterase type 5 inhibitors and endothelin receptor antagonists;
• multimodal pain management;
• regional analgesia techniques  (epidural, caudal analgesia) in the newborns in the postoperative period;
• correction of intra- and postoperative anemia by transfusion of auto-umbilical cord blood components in newborns;
• personalized instrumental monitoring of oxygenation parameters and main vital parameters including cerebral oximetry;
• mass spectrometry to detect the pathogens of infectious and inflammatory disorders in the newborns with malformations, and real time PCR to determine targeted antibacterial and antimycotic therapy in the perioperative period

In pediatrics

- cytogenetic tests and gene sequencing for malformations in the newborns;