Pediatric Surgical Endoscopy

Our pediatric surgical team uses endoscopic procedures to treat many types of conditions, from heart and lung defects to gastrointestinal diseases. We collaborate closely with pediatric specialist in many other departments to ensure our patients receive the comprehensive services they require.

Endoscopy surgery at Children’s National is:

• Specialized. Our surgical team is board-certified in general and pediatric surgery. We have extensive experience and training performing a wide range of endoscopic procedures for children, from the basic to the complex.
• Experienced. We perform a high volume of endoscopic surgeries every year, translating to a superior level of expertise for our team.
• Personalized. No two children are alike, and no two treatment plans are alike. We work with your child and family to tailor an individualized surgical plan that offers your child the best outcome possible.
• Child-focused. Your child’s team members have dedicated their careers to pediatric surgery. We combine our clinical excellence with a child-friendly, compassionate touch. In addition, we are the only facility in the region to guarantee 24/7 access to a pediatric anesthesiologist for your child’s pain management needs. Learn more about anesthesia at Children’s National.

Endoscopic surgery is a broad term that encompasses many different types of surgical procedures. The goal of any endoscopic procedure is to access the operating area using either an existing entryway to the body (such as the nose) or through small incisions. This avoids the need for a large incision. The type of endoscope we use depends on where we need to operate.

Common endoscopic procedures include:

• Arthroscopy for joint surgery. Learn more about arthroscopy in our Orthopaedic Surgery and Sports Medicine program.
• Bronchoscopy for lungs.
• Colonoscopy for the large intestine.
• Laparoscopy for the abdominal and pelvic area. Learn more about neonatal laparoscopic surgery.
• Upper gastrointestinal endoscopy for the esophagus and stomach. Learn more about esophageal surgery.
• Thoracoscopy for chest and thoracic cavity procedures.

Thoracoscopy uses an endoscope called a thoracoscope, which we insert through a small incision in the chest. This specialized type of thoracoscopic surgery is often called video-assisted thoracoscopic surgery (VATs). VATS has the added advantage of using video technology to guide the surgery, allowing us to perform more precise and targeted procedures.

We may recommend thoracoscopy for your child if we need to:

• Examine the lungs, the mediastinum (area between the lungs), and pleura (membrane covering the lungs)
• Perform a biopsy (obtain tissue or fluid samples) on the lungs, lymph nodes, mediastinum or pleura to confirm a diagnosis of infection or cancer
• Remove excess fluid
• Treat complicated pneumonias (empyema)
• Evaluate the extent of pulmonary (lung) disease and its effect on the surrounding structures
• Perform minimally invasive surgery such as esophagus surgery, lung surgery, or surgery for gastroesophageal reflux disease (GERD)
• Thymectomy
• Aortopexy
• Sympathectomy for sweaty palms (palmar hyperhidrosis)
• Lung removal for congenital lung lesions or solid tumors

There are many advantages to an endoscopic procedure compared to a traditional procedure. These include:

• Less pain
• Shorter hospital stay
• Shorter recovery
• Less risk of infection and bleeding

Specifically in children, benefits also include:

• Less chance of postoperative complications such as bowel obstruction
• Less risk of spine and back complications, such as scoliosis or shoulder weakness

Before the surgery, our pediatric anesthesiologist will administer general anesthesia to your child. Your child will be asleep the entire time and not feel any pain.

Each child’s surgery is different, depending on your child’s age, condition, and the specific procedure we are performing. Here is a general idea of what you can expect. We will:

1. Make a few small incisions in your child (instead of a large, open incision that we would use during traditional surgery).
2. Insert miniature surgical instruments and an endoscope into the incisions.
3. View the operating area on a nearby monitor. The endoscope transmits detailed, real-time images to the monitor.
4. Perform the procedure.
5. Remove the instruments and close the incisions.