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  • Dr. Erich Grethel | Austin Pediatric Surgery

    Meet Dr.Erich Grethel at Austin Pediatric Surgery! Learn more about how we're serving Central Texas. Erich Grethel, MD, FACS Meet Dr. Grethel Dedicated to improving pediatric surgical care, Dr. Grethel serves as the division chief of pediatric surgery as well as the surgeon champion for the Dell Pediatric NSQIP team, focusing on enhancing quality and outcomes for young patients. Dr. Grethel also leads the chest wall program at APS. My Journey to Pediatric Surgery "My outstanding mentors are what drew me to medicine and, eventually, pediatric surgery. From an amazing anatomy class in high school where I had hands-on experience with the human body, through medical school and then surgery training, where I had brilliant and inspirational role models in both general and pediatric surgery. These teachers loved medicine and pediatric surgery, and I could not help but share that joy. The beauty of pediatric surgery is that it combines the awe and fascination of surgery of all parts of the body with the opportunity to make a difference in the lives of kids and their families." My Clinical Focus "I love that as a pediatric surgeon, I treat a variety of different conditions, from hernias and lumps and bumps, to more complex problems, such as birth defects like diaphragm hernias and intestinal malformations. I counsel families, consult with maternal-fetal-medicine specialists, and care for newborns who may need surgery around the time of birth. I care for children who have forms of cancer that may be treatable with surgical therapies. I am the director of the pectus chest wall program at Dell Children’s. I also measure quality and outcomes as surgeon champion of Dell Children's pediatric arm of the National Surgical Quality Improvement Program." Services I Provide • Prenatal Counseling for Fetal Conditions • Inguinal Hernia and Hydrocele Repair • Complex Neonatal Surgery • Pectus Excavatum/Carinatum Program • Management of Traumatic Injuries • Surgical Urgent Care • Lumps and Bumps of the Head and Neck Degree & Training Medical School Harvard Medical School Residency The University of California, San Francisco Medical Center Fellowship Texas Children's Hospital Fetal Surgery: University of California, San Francisco Medical Center Board Certification American Board of Pediatric Surgery American Board of Surgery Memberships • American Academy of Pediatrics • American College of Surgeons • American Pediatric Surgical Association Providing trusted care when it matters most GET IN TOUCH

  • Dr. Dani Gonzalez | Austin Pediatric Surgery

    Meet Dr.Dani Gonzalez at Austin Pediatric Surgery! Learn more about how we're serving Central Texas. Dani Gonzalez, MD, FACS Meet Dr. Gonzalez "I am drawn to pediatric surgery by the breadth of cases that I can see in a single day. I enjoy both the variety in types of cases and the types of patients ranging from acute outpatient conditions to long standing conditions requiring long term follow-up to prenatal consults for expecting parents. Over the course of my career, I have developed an affinity for minimally invasive surgical techniques, including laparoscopy and thoracoscopy." My Journey to Pediatric Surgery "My passion for healthcare stemmed from seeing my grandparents have trouble navigating through complex medical systems as non-English speakers. I recall the difficulty they had understanding medical providers, which led to a poor understanding of their own healthcare needs. As a result, I developed a passion for ensuring that patients and their caregivers are armed with as much knowledge as possible in order to take an active role in their health. In addition to that, I really enjoy getting to know patients and their caregivers to fully understand what their needs are as patients. As a Pediatric Surgeon, I am humbled every day by the opportunity to care for babies and children." My Clinical Focus Dr. Gonzalez specializes in a wide range of pediatric surgical care, from outpatient procedures to long-term management of complex conditions and prenatal consultations. She is particularly passionate about minimally invasive techniques, including laparoscopy and thoracoscopy, which enhance recovery and outcomes for her patients. Services I Provide • Pediatric Trauma Care • Complex Colorectal and Bowel Management Program • Minimally Invasive (Laparoscopic/Thoracoscopic) Surgery • Complex Neonatal Congenital Defects • Pediatric Hernia Surgery • Ovarian Surgery • Removal of Pediatric Tumors • Soft Tissue Masses • Pediatric Gastrointestinal Surgery • Pediatric Oncologic Surgery • Thoracic Surgery Degree & Training Medical School Howard University College of Medicine Residency Icahn School of Medicine at Mount Sinai Fellowship Nationwide Children’s Hospital, The Ohio State University Board Certification American Board of Pediatric Surgery American Board of Surgery Memberships • American Academy of Pediatrics • American College of Surgeons • American Pediatric Surgical Association Providing trusted care when it matters most GET IN TOUCH

  • Dr. Julie Sanchez | Austin Pediatric Surgery

    Meet Dr.Julie Sanchez at Austin Pediatric Surgery! Learn more about how we're serving Central Texas. Julie Sanchez, MD, FACS Meet Dr. Sanchez Dr. Sanchez has called Austin home since 2001, where she balances a thriving surgical practice with her entrepreneurial spirit as co-founder of Spoonie Threads, an online clothing company designed for children and adults with special needs. Passionate about education, global health, and injury prevention, Dr. Sanchez is dedicated to making a meaningful impact both in and out of the operating room. My Journey to Pediatric Surgery "My initial passion was architecture. As an undergraduate at UT-Austin, my father encouraged me to think about medicine. I became a volunteer at Brackenridge Hospital. That's were I discovered my passion for medicine. Pediatric surgery allows me to care for children, empower parents and be a mentor. I enjoy meeting parents, caring for their newborn and seeing their child grow into a young adult. I'm blessed to be part of the journey." My Clinical Focus "My focus is to provide expert diagnosis and surgical treatment of a variety of general surgical conditions for children of all ages. My scope of practice ranges from perinatal consultations and hernia repairs to complex surgical management of tumors, birth defects and traumas." Services I Provide • Perinatal Consultations • Minimally Invasive Surgery • Neonatal Surgery • Breast and Ovarian Masses • Hepato-biliary Surgery • Surgery for the Special Needs Child • Gastro-intestinal Surgery Degree & Training Medical School University of Texas Southwestern Medical Center Residency SUNY at Brooklyn/Kings County Hospital Fellowship Pediatric Surgery - SUNY Brooklyn/ Kings County Hospital Pediatric Trauma - Johns Hopkins Hospital Board Certification American Board of Pediatric Surgery American Board of Surgery Memberships • Affiliate Professor of The UT-Dell Medical School • APSA-Global Pediatric Surgery Committee • Dell Children's Surgical Global Outreach • Fellow, American College of Surgeons • Fellow, American Pediatric Surgery Association • TETAF-NICU Surveyor • Texas Medical Association Providing trusted care when it matters most GET IN TOUCH

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Blog Posts (13)

  • My Child Has an Umbilical Hernia. How Worried Should I Be?

    What is an Umbilical Hernia? An umbilical hernia presents as a bulge or protrusion in your infant’s belly button. It is commonly found during the routine doctor’s visits they go to for the first few months of life. While this condition is visually alarming, it isn’t usually cause for concern. When the umbilical cord is cut, the ring typically closes on its own due to rectus muscle growth and fascial layer fusion. But when the fascia of the ring doesn’t close properly, intraabdominal contents may protrude. This results in a bulge in your child’s belly button . When your child cries, coughs, or strains to have a bowel movement, umbilical hernias may become more noticeable. However, when your child is quiet and resting, the bulge may diminish. Umbilical hernias do not usually cause pain, which should provide you some relief. How Common is an Umbilical Hernia? Umbilical hernias affect boys and girls equally. However, umbilical hernias are most common in premature babies and African-American infants. If your child falls into one (or both) of those categories, it is important to tell your pediatrician about any signs a hernia has developed. The good news is that 90% of umbilical hernias close on their own by the time a child is 4 to 5 years old. Often, doctors suggest delaying treatment due to a low rate of complications while waiting for the defect to close on its own. The size of the hernial ring is helpful to determine if it will close on its own. Umbilical hernias are most common in premature babies and African-American infants. If your child falls into one (or both) of those categories, it is something to keep an eye on and tell their doctor about. When Does an Umbilical Hernia Need Treatment? Although pediatric umbilical hernias are common among healthy infants, they are also associated with specific conditions such as common autosomal trisomies, metabolic disorders, and dysmorphic syndromes. It’s important that your doctor distinguishes whether your baby’s condition warrants further evaluation. If your infant’s umbilical hernia does not close on its own in their first few years of life, there are signs that will tell you it’s time to seek treatment: The bulge is firm, painful, or discolored or the hernia sticks out and can’t be pushed back into your infant’s abdomen. – these signs suggests the hernia is stuck and may be an emergency Your baby is over 4-5 years old and the hernia is still present. What is the Treatment for an Umbilical Hernia? The treatment for an umbilical hernia is umbilical hernia surgery. Due to how common pediatric umbilical hernias are, surgery is done in a single day. That means you can bring your child home the same day as the procedure. The procedure is performed while your baby is under general anesthesia. What Happens During Umbilical Hernia Surgery? The surgery for umbilical hernia is relatively straightforward. First, a small curved incision (resembling a smile) is made under your child’s belly button. Then the opening is closed with absorbable sutures and the overlying skin is closed with a combination of absorbable stitches below the skin and DERMABOND.  Umbilical Surgery Aftercare Hernia surgery recovery is simple. Immediately after surgery, your child’s belly button may be slightly swollen, but you can expect this to go away in a few weeks. Refrain from allowing your baby to participate in physical activity for 2-3 weeks post-surgery. Their follow-up appointment should be scheduled for 2-4 weeks after the procedure, when their doctor will evaluate your child’s recovery. There is a very small risk of recurrence of umbilical hernia once surgery is performed. If you notice that your child’s hernia has reappeared, call your Austin Pediatric Surgeon. Umbilical Hernia Treatment at Austin Pediatric Surgery Pediatric umbilical hernias are very common, and a routine surgery will fix the problem. If your child is showing signs of an umbilical hernia, contact Austin Pediatric Surgery to discuss treatment.

  • What You Need to Know About Infant Testicle Surgery

    While your newborn having an undescended testicle might come as a shock, it is not a huge cause for concern. This occurs in about 4% of infant males when, while growing inside the womb, the testicles develop inside of his abdomen and fail to move down into his scrotum.[1] Treatment for a undescended testicle is an orchiopexy procedure that requires either a laparoscopy or open surgery with general anesthesia. This type of procedure has a 95% success rate.[2] Why Would My Child Infant Need Testicle Surgery? Undescended testicles are a result of an infant male’s testicles, after developing in his abdomen, failing to drop into his scrotum while he is growing inside his mother’s womb. Your doctor can diagnose undescended testicles by examining the child. While undescended testicles aren’t inherently harmful, the complications from them can be. Infertility and testicular cancer are the main issues that males with undescended testicles can face later in life if an orchiopexy isn’t performed within 18 months after birth.  However, it’s recommended that you see a specialist or pediatric surgeon if your son’s testicle hasn’t descended or can’t be located within 6 months after birth. If it’s determined that there are no testicles at all versus undescended testicles, diagnosis immediately after birth can help prevent conditions that result from absent testicles. That’s why seeking out a surgeon you can trust early on can lower the risk of complications and give you peace of mind. What is the Process for Infant Testicle Surgery for a Child? Orchiopexy may require more than one surgery to repair. These surgeries are outpatient procedures, which means you can take your son home after surgery. But what happens during the procedure? Your son will undergo anesthesia so the surgery can be performed. Once your infant is asleep, their surgeon makes a small cut in his groin or may place a camera in the abdomen to find the testicle.  The surgeon examines the undescended testicle to ensure it’s healthy.  If necessary, a hernia sac repair might need to be done first. After any hernia is repaired, a second cut in the scrotum is made to create a pocket for the testicle to sit in. With a surgical tool, the surgeon pulls the undescended testicle down into the pocket they created.  To finish, the surgeon secures the two cuts made with dissolvable stitches that dissolve after a week or two. You and your son can go home about two hours after they undergo an orchiopexy procedure.  Pediatric Testicle Surgery: Questions to Ask the Surgeon When it comes to your child, there are no questions you can’t ask. Let’s go over a few of the most common so you feel confident scheduling testicle surgery for your son. How long do I withhold food for my son after surgery? The reason it’s recommended to limit food post-op is due to the effects of the anesthesia used during the surgery. Start with clear liquids, and consider avoiding rich foods for the day after surgery to avoid nausea.  What is the recovery time after an orchiopexy? Give your son 2-3 days after the procedure before he resumes daily activities. A few specific activities to avoid are jumping, running, and straddling toys like tricycles or rocking horses.  How do I control my son’s post-op pain? Since an orchiopexy isn’t a major surgery, your son’s discomfort can be managed with over the counter medicine like aspirin, acetaminophen, and ibuprofen. Applying ice four times a day for at least 10 minutes can not only control pain, but limit swelling of his groin. When do I need to call the doctor if I think something’s wrong? There are 5 symptoms that make it clear it’s time to call your doctor after your son undergoes testicle surgery: Heavy bleeding A high fever Severe pain Severe swelling Infection  What signs of infection do I need to look out for? An infection can indicate there is something wrong with the affected area. Signs to watch out for include pus or redness along the incision sites, a 101 degree or higher fever, and increased pain or swelling. Does Your Child Need Testicle Surgery?  It’s recommended that you find a surgeon you can trust before treatment is needed. That’s because surgery for undescended testicles is best done immediately to prevent future complications. If you’re looking for a pediatric surgeon who has experience with testicle surgery, Austin Pediatric Surgery has the best surgeons for the job. Sources: [1]: https://www.chp.edu/our-services/surgery-pediatric/patient-procedures/undescended-testicle-orchiopexy-repair-surgery [2]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4889701/ [3]: https://my.clevelandclinic.org/health/treatments/17297-orchiopexy [4]: https://www.chop.edu/treatments/surgery-undescended-testicles-orchiopexy

  • Understanding Pediatric Inguinal Hernia Repair Surgery

    Your top priority as a parent is keeping your child safe and free from pain or sickness. So what happens when they develop a condition that puts that at risk? You find the top children’s hospital in Austin to ensure they get the treatment they need to feel healthy again. If you notice your child has developed a bulge or swelling in their lower belly near their groin area, this points to a condition known as an inguinal hernia.  What is a Pediatric Inguinal Hernia? A pediatric inguinal hernia is a condition in which swelling of the groin area results from a hole that lets contents in the abdomen move into the groin. Inguinal hernias may allow intestines or other organs to pass through. These types of hernias are not caused by your child lifting something too heavy or straining. Instead, the defect is present at birth, and the straining leads to internal organs moving through the hole into the groin. Inguinal hernias do not heal on their own and require surgical intervention. Inguinal Hernias in Girls vs. Boys Inguinal hernias can affect both infant girls and infant boys, but it is more common in boys.  While in the womb, your child develops a short tunnel through the abdominal wall. This tunnel should seal off naturally before they’re born; if not, an inguinal hernia can form. The only difference between girls and boys with this condition is where the abdominal cavity connects.  Inguinal Hernias in Infant Girls With inguinal hernias in infant girls, the short tunnel connects the abdominal cavity to their labia. If the passage does not close, a pouch – an inguinal hernia – can form within the belly lining. Inguinal Hernias in Infant Boys With inguinal hernias in infant boys, the short tunnel connects the abdominal cavity to the scrotum. This tunnel is how their testicles – which grow inside the abdomen before birth – move into the scrotum. How is an Inguinal Hernia Diagnosed? Infant inguinal hernias are typically spotted during a routine exam by your child’s pediatrician. A bulge near their groin will be apparent, making it easy to diagnose. If additional testing is needed to confirm, an ultrasound may be performed. Since nearly all cases of this condition are present at birth and are most common among infant boys, your child’s provider should take extra care to spot an inguinal hernia before it becomes an emergency. What is the Treatment for Inguinal Hernia? The treatment for your child’s inguinal hernia is pediatric inguinal hernia repair surgery. Rarely do inguinal hernias cause pain unless the intestines have moved through the open passageway and gotten stuck. If this happens, your child’s bulge will appear firm and red. This will require that your infant undergo an emergency hernia repair surgery. Why Does Your Child Need Surgical Intervention for an Inguinal Hernia? Inguinal hernias do not heal on their own. Treatment is necessary because incarceration or strangulation of the hernia is possible and can be extremely painful and dangerous. “These types of hernias are not typically caused by your child lifting something too heavy or straining. Rather, the defect is present at birth, and the straining leads to internal organs moving through the hole into the groin.” What is the Inguinal Hernia Procedure? The surgery to fix an inguinal hernia is a straightforward outpatient procedure that takes less than an hour: Your child’s pediatrician makes a tiny incision in the groin Any intestines that have shifted down are moved back into the abdomen, and the hernia sac is closed off. A camera may be inserted to see if a hernia is present on the other side. The hole is closed with dissolvable sutures, and the wound is covered with Steri-Strips or DERMABOND. Recovery from infant hernia surgery is quick. Your child can leave the hospital a few hours after the procedure and resume normal activities usually within 2 weeks. Why Choose Austin Pediatric Surgery for Your Child’s Inguinal Hernia Repair At Austin Pediatric Surgery, we are highly experienced in the classic open repair as well as laparoscopic inguinal hernia repair and perform scheduled and emergency surgeries. At our pediatric surgery center, we perform this procedure using a minimal incision and without using mesh or screens whenever possible. During the procedure, a tiny camera may be used to check for any secondary hernias. When the procedure is finished, dissolvable sutures are placed. Infant Hernia Surgery: Don’t Wait Because surgery is necessary for your child’s inguinal hernia, you want to choose a pediatric surgeon in Austin you can trust. Call and speak with a member of our team today for more information.

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  • Psychiatry Consultation

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  • Psychology Consultation

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