IN-SITU EMERGENCY PEDIATRIC-SURGERY IN THE INTENSIVE-CARE UNIT

The role of surgery in the intensive care unit (ICU) remains unclear. Although previously shown not to increase morbidity for patent ductus arteriosus ligation, Broviac catheter insertion, and recently, general neonatal and paediatric surgery, there remains a reluctance to operat e on sick patients in the ICU (in-situ surgery, ISS). A retrospective study of 25 critically ill children and neonates who underwent ISS was performed. Surgery was aided by operating loupes and a high-intensity headlight. ISS was not associated with any morbidity, and although a 36% mortality occurred in this small series, in no case was this due t o ISS. ISS avoids the risks of transfer to the operating theatre and t he potential delays in theatre access. Our results suggest that ISS in a tertiary-level paediatric surgical hospital is safe and does not im pact adversely on clinical outcome.