CHOC Expands Pediatric Surgery Team, Expertise

The addition of a new CHOC Children’s pediatric surgeon with a unique expertise lays the groundwork for an expansion of CHOC’s surgical services for the smallest of patients.

While specializing in the full spectrum of pediatric surgery, Dr. Peter Yu has special expertise in the surgical treatment of babies before birth, and is working with hospital leadership to develop a multi-disciplinary fetal surgery program at CHOC in the near future.

Dr. Peter Yu

“I’m extremely happy to be at CHOC,” Dr. Yu says. “There is so much talent and potential here, as well as a pioneering spirit and willingness to undertake big things.”

Fetal surgery was uncharted territory about 30 years ago, Dr. Yu says. The following years, however, have seen many advances, including new techniques that allow surgeons to treat babies while in utero for conditions that are life-threatening or potentially debilitating.

With special training from the Children’s Hospital of Philadelphia, a pioneering institution in fetal surgery, Dr. Yu is determined to bring that level of expert care to CHOC and augment his team’s scope of services.

Also specializing in neonatal, thoracic and hernia surgery, Dr. Yu is board certified in general surgery, pediatric surgery and surgical critical care. Among his other goals are enhancing CHOC’s trauma program, advancing its minimally invasive surgery program, and furthering CHOC’s national reputation through quality patient care and innovative research.

As a medical student at the University of Missouri School of Medicine, Dr. Yu fell in love with the culture and technical aspects of surgery, as well as the potential to make sick patients better quickly.

“I realized that the best surgeons were kind, dedicated, hard-working and team players – traits that I really value,” he says. “When I discovered pediatric surgery, I felt it was a perfect fit for me.”

Dr. Yu completed his general surgery residency at UC San Diego, followed by a surgical critical care fellowship at Boston Children’s Hospital and a pediatric surgery fellowship at the Children’s Hospital of Philadelphia. He is currently working on a master’s degree in public health from Johns Hopkins Bloomberg School of Public Health.

In his spare time, Dr. Yu enjoys spending time with his three children and his wife, an intensive care nurse. He also enjoys surfing, basketball and competitive swimming on a local U.S. Masters swim team.

Call 714-364-4050 to schedule a consultation with a CHOC pediatric surgeon.

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Breast Masses in Teen Girls: Cancer or Benign Tumors?

Breast masses can be a cause of concern for adolescent girls and their parents.  Fortunately, the majority of these masses are benign tumors, and breast cancer remains very rare among this age group. The size of the mass, however, and associated pain may warrant surgery, says Dr. Maryam Gholizadeh, CHOC pediatric surgeon.  A young patient who detects a mass should be seen by a surgeon to evaluate her options before getting a needle biopsy.

Dr. Gholizadeh has experienced an increase in patients with breast masses, which may point to girls being diligent with breast self-examinations.   The patients are healthy and are experiencing hormonal changes fairly common in adolescence.  All of them are incredibly anxious.

“These young girls, who vary in ages from 13 to 17, are of course very scared, as are their parents.  I spend a lot of time educating them and, should surgery be necessary, reassuring them,” explains Dr. Gholizadeh. “As a woman, I have empathy for what these girls are feeling about their bodies and work really hard to make them feel comfortable with me.”

Surgery to remove the mass is performed under general anesthesia—administered by a pediatric anesthesiologist—an outpatient basis, with no hospitalization required.   Dr. Gholizadeh takes great care to preserve the shape of the breast and to minimize scarring by placing incisions either under the breast or around the nipple.   Her patients are home within a few hours of arriving at CHOC.  Patients can usually return to school within 48 hours and resume activities after two weeks.

“These young ladies are eager to get back to school, sports and other activities, and don’t want to be slowed down.  My goal is to provide the best surgical outcome for them, including a quick recovery,” says Dr. Gholizadeh.

A recognized expert in her field, Dr. Gholizadeh specializes in all areas of pediatric and neonatal surgery. Her clinical interests include pediatric oncology, thoracic surgery and minimally invasive surgery. Dr. Gholizadeh is board certified in general surgery and pediatric surgery.  She can be reached at 714-364-4050.

Will Your Newborn Need Surgery? Plan Now

The news comes as a shock, usually during the first prenatal ultrasound between the 16th and 20th week of pregnancy. Treatment planning, however, cannot begin too soon when a developing baby is diagnosed with a complex birth defect.

 

Some babies are born with complex conditions requiring surgery during the first few hours following birth. From the moment prenatal testing reveals an abnormality, CHOC Children’s is ready to help with the prenatal care and birth planning necessary to ensure the best-possible outcome.

CHOC has a trained and experienced team that includes perinatologists, neonatologists, pediatric surgeons and NICU nurses to guide families through the months before delivery. And families are essential to the planning process.

“The well-being of the child is surprisingly dependent on the well-being of the family, both psychologically and emotionally,” said Dr. David Gibbs, division chief, pediatric surgery, CHOC Children’s Specialists. “Preparation helps the family cope better, and the family that is coping better is able to provide better care for their child.”

According to Dr. Gibbs, recent advances in the care and outlook for babies born with abnormalities have come from closer prenatal coordination with perinatologists and families, combined with highly specialized neonatal intensive care. The CHOC NICU is rated by the American Academy of Pediatrics as a Level 4 NICU, the highest designation available and given only to facilities that also provide onsite surgical repair of serious congenital or acquired malformations.

That immediate access to the full NICU medical team, resources and support is critical for babies born with gastroschisis, a condition that requires surgery within the first hour following birth, and omphalocele, which must be corrected within the first few days. For the smallest and sickest, CHOC’s Small Baby Unit offers additional support to help babies grow and recover more quickly with fewer infections and setbacks.

For babies born with congenital diaphragmatic hernia, the CHOC Surgical NICU provides the optimal environment in which to stabilize and gain strength before surgery. One special room inside the CHOC NICU converts into a state-of-the-art operating room, allowing pediatric surgeons to perform delicate procedures within the unit.

And babies born with congenital cystic adenomatoid malformation (CCAM) may actually get to go home for continued evaluation months before surgery.

Deciding Where You’ll Deliver

Dr. Gibbs added that an important element of prenatal planning is deciding in advance where your baby will be born. Moms who know their baby will need surgery may choose to deliver at a hospital that is near a pediatric facility like CHOC. When the baby is born, the CHOC Transport Team is ready 24 hours a day to transport the baby to CHOC from hospitals throughout the region. Specially trained and equipped, this team uses ground and air transportation to travel to and from hospitals throughout Orange, Los Angeles, Riverside, San Bernardino and San Diego counties — and even beyond.

“We expect most children will do well and have normal lives,” Dr. Gibbs said. “But the first step is meeting with the perinatologist, pediatric surgeon and NICU team. Starting that relationship as soon as possible will make the process of coping with what may seem to be an overwhelming process a lot easier.”

CHOC’s surgeons provide cardiothoracic surgery, gastrointestinal (GI) surgery, general surgery, neurosurgery, urological surgery, otolaryngological (ENT) surgery, plastic surgery, ophthalmologic surgery and orthopaedic surgery.

Learn more about surgical services at CHOC.

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Matthew’s Story: Healing in the Surgical NICU

babies surgeryGrace Wu beams as she watches her son Matthew smiling and happy after enjoying his bottle.

“It’s good to see him so happy and active,” she says. “That he could do that makes me very, very happy.”

It’s a marked change from the days following Matthew’s birth almost four months ago.

As a newborn, he was diagnosed with volvulus, a condition wherein the intestine is twisted and can ultimately cut off blood circulation. Symptoms of volvulus include a distended stomach and intolerance to feeding, which Matthew exhibited.

The baby was quickly transferred to CHOC Children’s for emergency surgery at just three days old. CHOC surgeon Dr. Saeed-Ur-Rehman Awan repaired the malformation by performing an ileostomy, wherein the intestine is brought outside the body.

Next, Matthew needed time to heal his organs. He spent the next three months recovering in CHOC’s Surgical Neonatal Intensive Care Unit, a special part of the hospital’s main NICU dedicated to the care of babies who need surgery.

There, Matthew was under the care of a multidisciplinary team that included Dr. Irfan Ahmad, a CHOC neonatologist and co-director of the surgical NICU, and many other clinicians.

In the unit, the team cares for patients jointly, discussing the cases of children like Matthew as a group and forming a treatment plan that often calls for the expertise of other specialties at CHOC.

Another key component of the surgical NICU care team is parents and families. In Matthew’s case, his parents and grandfather, Jerry, partnered with clinicians on every stage of the baby’s care.

“Jerry was there every single day holding Matthew – even when he was crying,” Dr. Ahmad says. “He was a great member of the team, and he provided a lot of support.”

As Matthew began eating orally in small volumes as well as through intravenous methods, he geared up for a second surgery that would reattach his intestines. That procedure was performed just three months after the first.

After several more weeks of recovery, Matthew was able to eat fully from a bottle and was on his way home, much to the relief of his family.

“I was very worried because for the first time, I thought I might lose him,” Grace says. “I am very thankful for the care he’s received.”

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Surgical Services: Then and Now

Operating Room_lgIt’s been so much fun this past year to reflect on how CHOC has evolved since my first visit in 1964.

And I most certainly cannot forget the changes in surgical services, which CHOC has specialized in since its opening nearly 50 years ago.

CHOC has the latest surgical equipment, technology and techniques, including minimally invasive procedures and robotic surgery methods.

At CHOC’s Tidwell Procedure Center, fully-integrated operating rooms give surgeons full, wireless control of cameras and lights and the ability to view all of the room’s monitors and camera images, patient records and imaging reports on large, flat-screen displays as needed throughout the procedure.

Surgeons can also consult with other surgeons in other operating rooms and our hospital pathologists in real-time using video conferencing to discuss the surgery as it is happening.

Another big change since the hospital’s opening in 1964 has been the addition of child life specialists. These important CHOC staff members work with patients to help ease any fears and worries about a procedure, and to improve understanding of surgery through developmentally appropriate methods.

Surgery is scary for anyone of any age, but I know I would feel better knowing I was in CHOC’s care!

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Surgical Services at CHOC Children’s specializes in providing patients — from infants to young adults — with the most state-of-the-art services in a compassionate, family-centered environment. CHOC’s experience in exclusively treating children, teens and young adults makes it the expert in pediatric surgery.