What is the role of a specialist paediatric surgeon?
Paediatric surgery is the surgery of newborn babies (neonatal), infants & children. Many surgical specialities involve children but the term specialist Paediatric Surgeon is used to describe a general surgeon (rather than an ENT, orthopaedic surgeon etc) who treats newborn babies (neonatal) & children.
Although some of his work is minor surgery of children (eg hernia repair, surgery for undescended testis, appendicitis etc), specialist role is in the complex surgery of the newborn (neonatal surgery), major surgical diseases of children and surgery in children with complex medical disorders.
A specialist paediatric surgeons chooses to sub-specialise in paediatric urology. His training will be mostly as for specialist paediatric surgeons but in addition also have to spent time training in paediatric urology. He is involved in managing complex genitourinary problems in children. In most specialist paediatric surgery departments there will be one or more specialist paediatric urologists or specialist paediatric surgeons who devote most of their time to urology.
Do I need to see a paediatric surgeon or a paediatric urologist?
Our generation may be the last of the dual trained surgeons- Mr Misra has trained in both paediatric gastro-intestinal surgery and paediatric urology. Since some conditions have an overlap, you have an advantage in that you will not be referred out. For example, if a baby has an ano-rectal malformation with urinary reflux, Mr Misra can do both his ano-rectoplasty as well as cystoscopic deflux for his reflux.
How common is post operative vomiting?
Like he says on the home page, at most private hospitals where he works, the nursing staff compliment him on two things in particular- small incisions and exceptional operating speed, without compromising safety. Smaller incisions mean smaller scars and faster operating time means shorter anesthesia which results in reduced post operative complications. It is very rare to see vomiting after day care surgery.
Is it safe to have anaesthesia?
Mr Misra only works with experienced paediatric anaesthetists who can even do neonates on the NHS. For them, therefore, older infants and children are straightforward. Mr Misra only works with paediatric anaesthetists who have had at least 10 years experience in the field, many even longer.
Most of the thank you cards he receives after surgery actually mention the anaesthetist and the nursing staff more than himself - and that is good indication of excellent teamwork.
What are the risk of infections and how to prevent it?
In the private sector, since all patients have their own rooms and one does not have the sick, septic patients who are looked after on the NHS, his feeling is that post-operative infections are lower. Following elective day care surgery, most classified as clean operations, the incidence is less than 1%.
Having a good bath on the morning of the surgery certainly helps!
How long will my child be in the hospital?
Most are day cases while a few remain one night in hospital. A lot depends on how far you live from the hospital and your own comfort level of managing the post-operative period at home.
Is blood transfusion common during/after a surgery?
Blood transfusion is needed very rarely, e.g in cancer surgery, and you will always be warned about the possibility beforehand.
Will my child be on a special diet after surgery?
For day care surgery, we do advise light diet for a couple of days following surgery- pasta, yogurts, cereals, fruit and vegetables, sandwiches and soups etc.
For major surgery requiring in patient admission, we will carefully supervise the feeding pattern for the entire stay, under the close supervision of a dietitian.
Will my child be able to play sports after surgery?
For most day care surgeries, cycling, swimming, sports and PE is best avoided for 2 weeks. For contact sports, he gives specific advice depending on the surgery that he has done.
Since a lot of his patients are from abroad having had several operations before, sports may have to be avoided for even longer time- once again we will guide you after surgery.
Can a Jehovah’s Witness have a surgery?
Most certainly! Like he says above, blood transfusion is extremely rare in his practice and we would be extra careful in avoiding it here.
How long should my child starve before surgery?
Standard fasting times are:
What if my child has a cold or illness?
It is essential that you let us know immediately. Sometimes, in children it is impossible to find a good window between recurrent infections, and we may proceed to surgery but the final decision may have to be made by the anaesthetist on the day.
Should my child take any medication before surgery?
Can take all inhalers or any oral medications up-to 2 hours before surgery-but please do check with us for any complex medications.
How do we pack for our child's surgery?
If day care surgery, then 2 sets of clothes, one of which should be loose pyjamas. A couple of favourite toys; feeding bottles and milk; tooth brush and comb; some reading material and i-pad or tablet to keep them occupied; etc.
Referrals & Consultations
You may choose to bring a referral letter from your GP when attending Mr Misra's appointment.
Would like a second opinion only?
There are many reasons why you might choose to do this. You might feel that, rather than going through the NHS with its inevitable delays, you would actually like to pay for the opinion of a consultant who specialises in this field directly.
It could be that you want to be seen by a senior Consultant, a national expert, rather than a trainee on the NHS. You would certainly benefit from longer consultations in the private sector. Or, it may be you have been through the NHS system and would just like a second opinion from Mr Misra, for peace of mind.
How much will a private consultation cost?
When you book your consultation we will advise you the consultation fee. As a guide, you should expect to pay between £125 and £150, depending on the complexity of the condition. Please feel free to email us with any queries in this regard.
Do you need Private Healthcare Insurance?
It is NOT mandatory to have a Private Healthcare Insurance to see Mr Misra. If you have private healthcare insurance, please bring your insurance details and authorisation number with you to the appointment.
Information for General Practitioners (GP) NHS
Would like to refer to a specialist for comprehensive diagnosis?
If you are a GP, Paediatrician or other Healthcare Professional and would like to discuss a patient with Mr Misra please contact by email or ring his secretary to check his availability.
Mr Misra responds to email queries within a day. Please feel free to share your concerns, and attach the case summary and any relevant documents for his review. He will provide a detailed feedback to you after consultation, explaining the patient management plan and proposed course of action.
To enable him to provide a timely and efficient response, we ask GP's & parents to provide us with an up-to-date medical report and as much information about the patient. You may choose to use our Online GP Patient Referral Form.