Directorate of Paediatric Surgery

Paediatric surgery crosses several surgical specialities including:

• General surgery
• ENT surgery
• Ophthalmology
• Urology
• Trauma and Orthopaedics

Paediatric General surgery

This surgery is based around the paediatric surgical needs of a large District General Hospital. The case mix includes:

• Testicular/scrotal conditions, circumcisions, hernia surgery and anal-rectal conditions.
• Chest wall/axilla/breast conditions
• Abdominal pain (investigation and surgery) is investigated and treated
• A current innovation is the development of endoscopic and laparoscopic surgery in children’s gastro-intestinal conditions.

This is a service driven specialty, as most of the conditions treated have clear treatment pathways. There are strong clinical links with both the Royal Manchester Children’s Hospital and Alder Hey Hospital including the initial assessment and referral of complex paediatric conditions. This also includes those that may require multi-disciplinary team and intensive care treatment. There is a Children’s Medical Assessment Unit with consultant paediatrician support. 

Orthopaedic Paediatric Surgery

This is an integral part of the Trauma and Orthopaedic department.  Trauma and fracture cases in children are treated by 16 of the ‘on call’ consultants through fracture clinics and trauma lists. There is a Children’s Medical Assessment Unit with consultant paediatrician support (joint care) for all paediatric orthopaedic admissions (elective and emergency).

Elective paediatric orthopaedics is undertaken by two consultants who also give clinical advice to orthopaedic and paediatric colleagues when required (including trauma and infective cases). 

Elective conditions treated include: 

• Developmental Dysplasia of the Hip (DDH)
• Congenital Talipes Equino-varus (clubfoot)
• Cerebral palsy, neuromuscular, syndromic and complex genetic conditions.

This unit is considered to be a sub-regional unit for elective paediatric orthopaedics due to the complex nature of the paediatric orthopaedic practice and surgical techniques. The department is supported with highly skilled consultant paediatric orthopaedic anaesthetists and paediatricians.

The unit has strong education links to:

• The University of Central Lancashire
• The University of Lancaster
• The British Society of Children’s Surgery (BSCOS)
• The Royal College of Surgeons of Edinburgh
• Public Health England (PHE)
• The Northwest Orthopaedic Association.

The consultants have been involved in lecturing and teaching on national and regional registrar courses for children’s orthopaedics. They are members of regional and national specialist children’s orthopaedic societies (including past committee members). The training programme for the specialist registrars in children’s orthopaedics in the North West of England was led from ELHT for more than 10 years.  Expert Advice has been requested and given to PHE and NIPE in developing national policy (England) for screening for hip pathology in developmental dysplasia of the hip (DDH). The unit is a nationally and internationally recognised centre in the development of, delivery and audit/research in hip joint screening for DDH. Research on DDH from the unit has been awarded regional and national prizes. In 2006, the national meeting of the British Society for Children’s Orthopaedic Surgery (BSCOS) was hosted in Blackburn.

There is an impressive track record in research, with over 50 papers published on a wide range of children’s orthopaedic conditions in peer reviewed international journals. The department has also given many prestigious presentations at national and international meetings and societies. Over 10 regional and national research awards and prizes have been received. Unit research has been cited in national and international guidelines for screening in DDH across the UK, Europe and North America. National and international paediatric orthopaedic journals such as the Bone and Joint Journal  and the Knee are peer reviewed by consultants in the unit. The unit has submitted cases for the BOSS, NIHR funded multicentre trials study for Perthes disease and Slipped Capital Femoral Epiphysis of the hip joint and one consultant is a Cochrane reviewer (DDH).

Mr Choudry is the current secretary for the Northwest Children’s Orthopaedic Group (prior to this Professor Paton was the secretary for 20 years). This group runs regular regional post-graduate meetings on complex children’s orthopaedic conditions.  A successful national course on Children’s Orthopaedics run from Alder Hey Hospital Liverpool was co-developed and undertaken in association with other consultants in the North West for 14 years.