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The future of paediatric surgery outside specialist paediatric hospitals
A O'Donovan1, H Varadaraj, P V Delaney
1Department of General Surgery, Mid-Western Regional Hospital, Limerick, Ireland.
Insights
General surgeons in Ireland provide essential pediatric surgical services. While the Mid-Western Health Board shows a low morbidity rate, future training is crucial to sustain this vital service.
Area of Science:
- Surgical Services
- Pediatric Surgery
- Health Policy
Background:
- General surgeons in Ireland offer pediatric surgical care to remote populations.
- This review focuses on the Mid-Western Health Board (MWHB) region.
Purpose of the Study:
- To assess general pediatric surgical services in the MWHB.
- To inform future healthcare policy decisions in Ireland regarding pediatric surgical care.
Main Methods:
- A retrospective review of pediatric surgical workload at Mid-Western Regional Hospital (1995-2000).
- Data collected included operations performed, surgeon level, morbidity, and mortality.
Main Results:
- 3,166 pediatric surgical patients were treated by trained general surgeons and a urologist.
- An increase in day cases (55% to 70%) and consultant-led operations (40% to 67%) was observed.
- No mortality and a morbidity rate below 1% were recorded.
Conclusions:
- Pediatric surgery and urology services in the MWHB are adequately provided by trained surgeons.
- Future service provision is at risk due to insufficient training opportunities for new surgeons.
- Recommendations include expanding specialist services, adapting surgical training, or implementing proleptic appointments.
Background:
In Ireland, general surgeons provide paediatric surgical services to patients remote from specialist paediatric units.
Aim:
To review general paediatric surgical services in the Mid-Western Health Board (MWHB) region with a view to informing future policy decisions in Ireland.
Methods:
From 1995 to 2000, the paediatric surgical workload at the Mid-Western Regional Hospital was reviewed. Operations performed, level of operating surgeon, morbidity and mortality were recorded.
Results:
There were 3,166 general paediatric surgical patients cared for by three general surgeons and one urologist, all with paediatric surgical training. There was an increase in day cases (55% to 70%) and operations at which the consultant was the main operator (40% to 67%). There was no mortality and the morbidity rate was less than 1%.
Conclusions:
General paediatric surgery and urology is well provided for in the MWHB by appropriately trained surgeons. Lack of opportunity for surgeons in training to obtain general paediatric surgical experience will put this service at risk as the current cohort of surgeons retire. Expansion in specialist paediatric surgical services, changes in general surgical training to include general paediatric surgery or proleptic appointments may be required.