Pediatric Surgery Referral Guidelines

The Pediatric Surgery department at Valley Children’s specializes in the repair of birth defects and acquired conditions in infants, children and adolescents. Surgeons perform about 3,500 pediatric surgeries a year and more than 200 different surgical procedures, some common and others rare.

Conditions treated include:

• Hernias (inguinal, umbilical, ventral) and hydroceles
• Undescended testes
• Chest wall deformities (pectus excavatum and carinatum)
• Congenital anomalies requiring surgery (gastroschisis, diaphragmatic hernia, atresia)
• Lung and chest masses, cysts
• Blood disorders requiring splenectomy
• Hepatobiliary disease (biliary atresia, choledochal cyst, gallbladder disease, tumors)
• Gastroesophageal reflux disease, feeding disorders requiring gastrostomy
• Anorectal and colon malformation (Hirschsprung’s disease, imperforate anus, fecal incontinence)
• Head and neck (masses, thyroid disease/thyroglossal duct cyst, branchial cleft remnant)
• Tumors (neck, chest, abdomen, pelvis, extremity, excluding hands/feet)

Procedures are performed on an inpatient, outpatient and emergency basis. A high volume of surgical cases, combined with diverse training from national centers of excellence, give our surgeons a level of experience not found elsewhere in our region. Our physicians’ expertise means a lot to our patients and their families. Often our patients experience shorter lengths of stay and better outcomes. 

Valley Children’s ranks highly in the American College of Surgeons National Surgical Quality Improvement Program. Whenever possible, our surgeons use less invasive surgical techniques (i.e., laparoscopies with small incisions), adopting nationwide best practices and providing compassionate care through multidisciplinary teams that have broad experience with children. We are one of the few pediatric centers on the West Coast that offer a comprehensive robotic surgical program. We also offer minimal blood loss techniques whenever appropriate. Our pediatric surgeons work closely with the hospital’s subspecialists and subspecialty surgeons. 

A pediatric surgeon has completed a five-year residency in general surgery, plus a two-year fellowship in pediatric surgery, and is certified by the American Board of Surgery in both general and pediatric surgery.

The following patients should be referred to a pediatric surgeon:

• Infants and children with perforated appendicitis should be cared for by a pediatric surgeon. If a non-pediatric surgeon makes the diagnosis or suspects the diagnosis of perforated appendicitis in a child, the child should be transferred to the care of a pediatric surgeon.
• Infants, children, and adolescents with solid malignancies should be cared for from the outset by a pediatric surgeon or pediatric surgical specialist and a pediatric medical cancer specialist.
• Minimally invasive procedures (e.g., laparoscopy, thoracscopy) in infants and children should be performed by a pediatric surgeon trained in these techniques.
• Infants and children with medical conditions that increase operative risk (e.g., congenital heart disease) who must undergo a common surgical procedure (e.g., hernia repair) should be cared for by a pediatric surgeon.