Overview of neonatal surgery

Neonatal surgery emerged as a fledgling in the 1930s and 1940s in restricted regional centers of the world where the pioneer pediatric surgeons were located. It galvanized into a bona fide pediatric surgical subspecialty during the 1950s, lead by those children's hospitals that developed neonatal surgical units and training centers. These institutions produced increasing numbers of highly trained young pediatric surgeons who fanned out to bring their expertise to other academic surgical centers. The 1960s saw both neonatologists and pediatric surgeons enriching the care of newborns in community and private hospitals in developed countries. Pediatric anesthesiologists, pediatric radiologists, and perinatologists joined ranks in the 1970s, extending care to the fetus as well as the newborn. Technologic developments such as ultrasound, computer tomography (CT), sophisticated ventilators, and advances in parenteral nutrition revolutionized both diagnosis and treatment. Magnetic resonance imaging, ECMO, cine CT, and sophisticated improvements in other areas have increased the scope and expanded the horizons of neonatal care in the 1980s, improving treatment yield and reducing morbidity and mortality of newborns who suffer from major medical and surgical diseases. Singapore, Hong Kong, Korea, and Taiwan recently have built neonatal surgical centers where high-quality care and training is offered. Almost every developing country now has surgeons who are partially or completely trained in pediatric surgery and who are on the faculty of their major medical teaching centers. There is every reason to believe that the next pediatric surgical issue of Clinics in Perinatology will describe further revolutionary advances in the care of the newborn patient, in areas now sacrosanct to perinatologists, neonatologists, and pediatric surgeons of this generation.