Learn about Austin Pediatric Surgery, where skilled pediatric surgeons provide state-of-the-art care. Our mission: expert surgical care with a compassionate touch. About Us For over four decades, Austin Pediatric Surgery has been here for Central Texas families. We are honored to partner with you in caring for your child and ensuring they receive the compassionate, expert care they deserve. Caring for Central Texas Families Since 1972 Austin Pediatric Surgery was founded in 1972 with a mission to provide expert surgical care to children in the Central Texas community. Over the decades, our team has grown into a group of highly skilled pediatric surgeons and care providers, united by a shared commitment to compassionate, state-of-the-art care. From the early days of our practice to today, we’ve proudly served as a dedicated pediatric surgical group in the greater Austin area, helping families navigate their child’s surgical needs with confidence and comfort. Our Mission & Vision At Austin Pediatric Surgery, our mission is to deliver the highest level of cutting-edge pediatric surgical care to families and children across Central Texas. We envision a future where every child has access to compassionate, multidisciplinary care that supports their health, growth and well-being. A Legacy of Excellence & Leadership As the region’s leading pediatric surgical group, we’ve achieved numerous milestones, including the development of world-class programs for chest wall and colorectal surgery, as well as maintaining the only Level 1 Pediatric Trauma Center in Central Texas. Our team’s expertise, coupled with advanced technology and innovative techniques, ensures your child receives the best possible care. MEET YOUR TEAM Our Core Values Gold Standard Care We are committed to excellence, providing exceptional care to all children, regardless of socioeconomic status or insurance coverage. Family-Centered We work closely with families to ensure they feel supported and informed every step of the way. Team Approach Our surgeons, staff and specialists work seamlessly together to deliver comprehensive, individualized care. Why Families Trust Us From the moment you walk through our doors, our goal is to make your experience as stress-free and comfortable as possible. Whether your child is undergoing a routine procedure or requires specialized care, you can trust that our skilled team will treat them with kindness, respect and the highest level of expertise. Where Excellence Meets Compassion MEET YOUR TEAM

Expert care for cysts, abscesses and skin masses. Safe and effective treatment tailored to children’s needs. Skin Masses & Infections SKIN MASSES SKIN INFECTIONS PILONIDAL DISEASE Our pediatric surgeons specialize in diagnosing and treating a variety of skin masses and infections, ensuring your child receives expert and compassionate care. Skin Masses What are Skin Masses? Skin masses are lumps or bumps beneath the skin, most often benign and non-cancerous. Possible Diagnoses Include: Cysts: Dermoid, epidermoid, or pilonidal cysts Malformations: Lymphatic or vascular malformations Growths: Lipomas, pilomatrixomas, or neurofibromas Rare Conditions: Pyogenic granulomas, skin tags, or liposarcomas Diagnosis and Treatment Diagnosis is based on a physical exam, sometimes aided by ultrasound. Surgery to remove the mass is often recommended and typically performed as an outpatient procedure under anesthesia. Skin Infections What are Skin Infections? Skin infections can cause abscesses, which are pockets of infected fluid beneath the skin. Treatment Incision and Drainage (I&D): A small surgical cut drains the abscess, often leaving a temporary drain in place. Home Care: Wound cleaning with warm soapy water; antibiotics may be prescribed. Follow-Up: Drain removal occurs 7-14 days after surgery in our office. The surgeons at Austin Pediatric Surgery are experienced in treating skin masses and infections, ensuring safe and effective care for your child. We can often see patients on the same day symptoms arise. Contact us to schedule a consultation. Pilonidal Disease Pilonidal Disease is a very common condition in the lower back/buttock cleft where a cyst can form and the area become infected. Symptoms can range from asymptomatic to mild infections to severe abscesses and open wounds. There is a range of treatments depending on the severity of disease and the presence of infection.

From hernias to complex congenital anomalies, our pediatric surgeons treat a variety of conditions. Discover how we provide minimally invasive and specialized care. Conditions we Treat At Austin Pediatric Surgery, we are dedicated to providing expert surgical care for infants, children, and adolescents. Our pediatric surgeons specialize in treating a wide range of conditions often identified by primary care providers, using advanced techniques tailored to the unique needs of young patients. Whenever possible, we utilize minimally invasive procedures, which involve small incisions, resulting in quicker recovery times, reduced discomfort, and minimal scarring. Explore the conditions we treat and discover how our skilled team can support your child’s journey to health. If you have any questions, we’re here to help! Comprehensive Care in Pediatric Surgery At Austin Pediatric Surgery, we are dedicated to providing a broad range of specialized surgical care for infants, children, and adolescents. Our team combines advanced techniques with compassionate care to ensure the best outcomes for every patient. From minimally invasive procedures to complex surgeries, we focus on tailoring treatment to meet each child’s unique needs. Explore our services to learn how we can support your family, and feel free to reach out with any questions about how we can assist your child on their journey to health. Hernias Head & Neck Oncology Chest Wall Deformities Inflammatory Bowel Disease Gastrointestinal Surgery Complex Thoracic Surgery Neonatal Surgery Liver & Gallbladder Colorectal Disease Pediatric Trauma Skin Masses & Infections Genitourinary Ovarian Masses & Cysts Breast Disorders MEET YOUR TEAM

Specialized surgical care for undescended testicles, hydroceles, hernias, and circumcisions, with a focus on children’s unique needs. Genitourinary Surgery PHIMOSIS (CIRCUMCISION) UNDESCENDED TESTICLE HYDROCELE/HERNIA At Austin Pediatric Surgery, we specialize in diagnosing and treating genitourinary conditions in infants, children, and adolescents. Our experienced surgeons provide expert care to ensure the best outcomes for your child’s health and development. Contact Austin Pediatric Surgery to learn more about our genitourinary care and to schedule an appointment. We are here to provide expert guidance and personalized treatment for your child. Phimosis (Circumcision) What is it? Phimosis occurs when the foreskin cannot be retracted over the glans of the penis. Treatment Circumcision may be performed for medical reasons, including infections or scarring, or for personal or cultural preferences. The procedure is offered for children of all ages and is typically performed as an outpatient surgery. Undescended Testicle (Cryptorchidism) What is it? A condition where one or both testicles fail to descend into the scrotum before birth. Treatment Surgery (orchiopexy) is typically recommended between 6-12 months of age to prevent complications such as infertility or testicular cancer. The procedure involves repositioning the testicle into the scrotum. Hydrocele & Hernia What is it? Hydrocele: A fluid-filled sac around the testicle, often causing swelling in the scrotum. Hernia: A condition where abdominal tissue pushes through a weak spot in the groin. Treatment Both conditions are treated surgically to prevent complications like pain or tissue damage. These outpatient procedures typically result in quick recovery times.

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

Request your appointment online with Austin Pediatric Surgery. Request Appointment Please call 911 if you have a medical emergency Cancellation / No Show Policy Please call to cancel or reschedule an appointment at least 24 hours prior to the appointment you cannot attend. Patients who fail to show up for an appointment, or fail to cancel an appointment more than once, will be billed a charge of $25 per missed appointment. (512) 708-1234

Expert care for thyroglossal duct cysts, branchial cleft cysts, thyroid conditions, and tongue-tie surgery. Compassionate pediatric surgeons in Austin. Head & Neck Surgery THYROGLOSSAL DUCT CYST BRANCHIAL CLEFT CYST THYROID DISEASE / SURGERY TONGUE TIE SURGERY Our team of pediatric surgeons specializes in diagnosing and treating various head and neck conditions. Whether congenital or acquired, we’re dedicated to providing expert care tailored to your child’s unique needs. Thyroglossal Duct Cyst What is it? A thyroglossal duct cyst is the most common neck condition that your child can be born with. It can look like a painless lump in the upper neck, which may move when swallowing or sticking out the tongue. They can become infected, which is why we recommend removing them when they are diagnosed. Evaluation and Diagnosis Diagnosis is usually made through a physical exam. An ultrasound can be used to confirm the cyst and ensure the thyroid gland is normal. Treatment Surgery (the Sistrunk procedure) removes the cyst and its associated duct under general anesthesia. Infections must be treated first. Children may go home the same day as the procedure or stay overnight. Recurrence is rare, but possible. Follow-Up Care Post-surgery instructions will include wound care and activity guidelines. Pain is managed with over the counter medications. Follow-up appointments occur 2-4 weeks after surgery. When to Call the Doctor Contact your doctor if signs of infection (redness, swelling, or fever), neck swelling, or other concerns arise. Branchial Cleft Cyst What is it? This neck condition your child is born with is from abnormal development of the different glands and structures on the side of the neck. Most commonly, it appears as a painless swelling or a small skin opening that may intermittently drain fluid. Evaluation and Diagnosis Diagnosis is based on a physical exam and ultrasound. CT or MRI may be needed for unclear cases. Treatment Surgery removes the cyst or sinus under general anesthesia, with infections treated first. The procedure lasts 1-2 hours, and your child may go home the same day or stay overnight. Recurrence risk is low. Follow-Up Care Wound care and pain management instructions will be provided, and a follow-up visit is scheduled 2-4 weeks post-surgery. When to Call the Doctor Contact your doctor if signs of infection (redness, swelling, or fever), neck swelling, or other concerns arise. Thyroid Disease What is it? The thyroid gland regulates metabolism and other body functions. Conditions include thyroid nodules, hyperthyroidism, and hypothyroidism, which may present as lumps, fatigue, or mood changes. Evaluation and Diagnosis Diagnosis involves a physical exam, blood tests, and ultrasounds. A biopsy may be recommended for thyroid nodules. Treatment Certain thyroid conditions require surgery to remove a portion of the thyroid or the entire thyroid. Our group has a specialty program dedicated to specifically taking care of children with surgical thyroid conditions, led by Dr. Jeffrey Horwitz . Follow-Up Care Post-surgery care includes monitoring hormone levels, wound care, and medication for those with full thyroid removal. A follow-up visit occurs 1-2 weeks post-surgery. When to Call the Doctor Contact your doctor if signs of infection (redness, swelling, or fever), neck swelling, or other concerns arise. Thyroid Surgery Program Although thyroid disease is less common in children compared to adults, occasionally surgical issues arise. Most commonly this is for an overactive thyroid gland (hyperthyroidism) or a concerning thyroid nodule. Treating pediatric thyroid disease requires a multidisciplinary approach. As the lead surgeon of our Thyroid Surgery Program, Dr. Jeffrey Horwitz works closely with our partners in pediatric endocrinology, pediatric radiology and pediatric pathology. In addition, because recent studies have suggested that high volume thyroid surgeons (performing > 30 cases/year) have improved outcomes, Dr. Horwitz has partnered with Dr. Teresa Kroeker, one of the region’s leading adult thyroid surgeons. This collaboration between pediatric surgeons and a high-volume adult thyroid surgeon optimizes the care of children with surgical thyroid disease conferring the benefits of both a high volume thyroid surgeon and high volume pediatric surgical care. Tongue-Tie Surgery What is it? Tongue-tie (ankyloglossia) occurs when a tissue band restricts tongue movement. It may interfere with feeding or speech. Treatment Pediatric tongue-tie surgery releases the tongue and is performed under general or local anesthesia, depending on age. Recovery involves minimal discomfort managed with over the counter medication.

Meet Dr.Jessica Naiditch at Austin Pediatric Surgery! Learn more about how we're serving Central Texas. Jessica Naiditch, MD, FACS Meet Dr. Naiditch Dr. Naiditch is a board-certified pediatric surgeon specializing in the surgical management of inflammatory bowel disease, trauma, and oncology. She leads the Austin Pediatric Surgery Inflammatory Bowel Disease Team and serves as the Trauma Medical Director at Dell Children’s Medical Center. She has published extensively on topics such as lung biopsy techniques, drug resistance in neuroblastoma, intussusception, cloacal exstrophy and tracheal remnants, reflecting her dedication to improving outcomes for pediatric patients. My Journey to Pediatric Surgery "I cherish the privilege to help children. My motivation throughout medical school and residency has been my drive to become a pediatric surgeon. I am driven by the potential for cure during an operation. At the same time, I am also deeply humbled by parents who trust us with the lives of their children." My Clinical Focus "As a pediatric surgeon, I have experience in all aspects of neonatal and pediatric surgery. Minimally invasive surgery is integrated into my practice as much as possible. My strong interest in surgical oncology and inflammatory bowel disease keeps me engaged with my medical colleagues to ensure comprehensive multidisciplinary care. As the Trauma Medical Director at Dell Children’s Medical Center, I work to ensure the injured children in Austin received the best care possible. I provide surgical care for children with congenital anomalies. I also provide care for children with surgical issues involving the neck, chest and abdomen." Services I Provide • Pediatric Trauma Care • Removal of Pediatric Tumors • Pediatric Chest Surgery • Pediatric Hernia and Hydrocele Repair • Neonatal Surgery • Minimally Invasive Surgery • Inflammatory Bowel Disease Degree & Training Medical School University of Pittsburgh School of Medicine Residency McGaw Medical Center at Northwestern University Feinberg School of Medicine Fellowship University of Texas Southwestern 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

Compassionate surgical care for imperforate anus and other colorectal disease and anorectal conditions, helping children thrive with expert solutions. Complex Congenital Colorectal Disease ANORECTAL MALFORMATIONS BOWEL MANAGEMENT At Austin Pediatric Surgery, we specialize in the comprehensive care of children with complex colorectal and bowel conditions. From congenital issues like anorectal malformations and Hirschsprung Disease to chronic constipation and fecal incontinence, our expert team offers individualized treatment plans designed to improve your child’s quality of life. We combine advanced surgical techniques with compassionate, family-centered care, guiding you through every step—from diagnosis and treatment to recovery and long-term bowel management. Our goal is to ensure your child thrives with predictable bowel function, enhanced self-esteem, and overall well-being. Anorectal Malformations Anorectal malformations (Imperforate Anus) are congenital defects where the anus is absent or improperly formed, preventing normal stool passage. This condition occurs in about 1 in 5,000 births. Types of Anorectal Malformations Absent Anal Opening: No opening for stool to pass. Misplaced or Small Anal Opening: Located incorrectly or too small. Fistula Connections: Abnormal connections between the rectum and the urinary system or vagina. Cloaca (Females): A single opening for the intestine, urethra, and vagina. Diagnosis Diagnosis is made through physical exams at birth and confirmed with additional tests for associated anomalies: Ultrasound: Evaluates kidneys. X-Ray: Checks intestine and spine. Echocardiogram: Assesses heart function. Treatment Low Rectum or Abnormal Opening Single surgery (anoplasty) moves or creates the anal opening. High Rectum with No Opening Three-Staged Surgery: Colostomy: Creates a stoma for stool passage. Neo-Anus Creation: Positions the rectum correctly and repairs fistulas. Colostomy Closure: Restores normal stool passage. Post-Surgical Care and Recovery Hospital Stay: Discharge occurs once feeding, bowel function, and pain are well-managed. Home Care: Includes ostomy care, preventing diaper rash, and managing constipation. Long-Term Management: Children with high rectal defects may require a bowel management program for proper function. Austin Pediatric Surgery is here to guide you through every step, ensuring the best outcomes for your child’s care and recovery. Contact us for support or consultation. Bowel Management Our Bowel Management Program is for children with constipation and/or fecal incontinence. We work with children and families to achieve a goal of predictable bowel movements to improve quality of life. This program is designed to avoid bowel accidents and diaper dependence, which can lead to remaining clean and improved self-esteem. We offer daily feedback via email or a phone call to achieve the individualized goals discussed at the initial meeting. Fecal incontinence can be a result of congenital conditions, constipation, or issues with muscle weakness or injury. Symptoms of this can be mild leakage of stool when passing gas to no control of bowel movements with daily accidents. Some congenital conditions our program will be successful for are: Imperforate anus/anorectal malformation Hirschsprung Disease Idiopathic constipation Fecal incontinence Cloacal exstrophy Spina bifida What to expect Your family will meet with the team to review the past medical and surgical history and type of bowel control issues your child is experiencing. After a physical exam and radiographic imaging, an individualized program will be created to achieve the goals of bowel control discussed for your child. This can be achieved with dietary changes, medications such as laxatives, and/or enemas. We understand the importance of daily communication, dedication, and teamwork between our medical providers and families to achieve success.

Specialized care for chest wall deformities, including pectus excavatum and pectus carinatum with minimally invasive techniques for faster recovery. Pectus Chest Wall Deformities PECTUS EXCAVATUM PECTUS CARINATUM MIXED CHEST DEFORMITY OUR PECTUS PROGRAM Pectus Excavatum What is it? Pectus excavatum is characterized by a sunken chest caused by the sternum pressing inward. It often becomes more pronounced during growth spurts in childhood or adolescence. Signs and Symptoms Sunken appearance of the chest wall Decreased exercise tolerance Negative self image Evaluation and Diagnosis Diagnosis involves a physical exam, chest CT scans, and tests like echocardiograms and pulmonary function assessments to determine severity. Treatment Nuss Repair (Minimally Invasive): Placement of a metal bar under the sternum to correct the defect, removed 2-3 years later. Ravitch Repair (Open Surgery): Removal of cartilage and placement of a strut under the sternum to reshape the chest. Non operative treatments are sometimes used in unique cases Follow-Up Care Post-surgery follow-ups include monitoring with chest X-rays and restricting contact sports for a brief period of time. The bar is typically removed after 2-3 years. About Pectus Excavatum Pectus excavatum is an indentation to the chest wall that occurs in 1 in 300 people. Patients with pectus excavatum may complain of shortness of breath, especially while exercising, or an inability to keep up physically with their peers. They may feel embarrassed or ashamed of their physical appearance, and this impaired body image can result in lower self-esteem and impaired quality of life. Pectus excavatum often requires an operation to elevate the sternum, potentially improving heart and lung function, as well as improving the appearance of the chest. An extensive evaluation will help determine if a patient is a surgical candidate. At the patient’s initial consultation, we will discuss if and when additional workup testing should be considered. The surgeons perform the Nuss procedure to correct pectus excavatum. The surgery involves two small incisions made on either side of the chest. One or more bars are guided across the chest and then rotated to lift the sternum. Thoracoscopy allows the surgeons to see inside the chest with a camera during the procedure. We utilize a multimodal approach to pain control to ensure patients are able to return to their normal activities as soon as possible. One aspect of this pain control is cryoablation, which uses extreme cold to temporarily freeze targeted nerves in the chest wall. We restrict certain activities for a short period of time, but within a limited time period our patients are able to resume all activities including contact sports. At Austin Pediatric Surgery, an enhanced recovery (ERAS) pathway was created by our team of surgeons, advanced practice providers, anesthesiologists, nurses, physical and occupational therapists, pharmacists, and Child Life Specialists. ERAS is a patient-centered and evidence-based approach to optimize surgical outcomes. This team developed a pectus pathway to improve postoperative pain control, encourage early mobility, and decrease hospital length of stay. This pathway optimizes care before, during, and after your surgery. Pectus Carinatum What is it? Pectus carinatum causes the sternum to protrude outward, leading to a pigeon chest appearance. Signs and Symptoms Asymmetric chest appearance Negative self image Chest pain or breathing difficulties Evaluation and Diagnosis Diagnosed via physical exams, sometimes supplemented with chest X-rays for bony abnormalities. Treatment Brace Therapy: Effective for non-rigid cases, requiring continuous wear for 3-6 months. Ravitch Repair (Surgical): Reserved for severe or brace-resistant cases, involving cartilage removal and sternum reshaping. Follow-Up Care Brace therapy patients are monitored for progress, while post-surgery patients are seen regularly to ensure proper healing. About Pectus Carinatum Pectus carinatum is a less common variant of a pectus anomaly and occurs when the sternum and ribs protrude outward. Many patients with pectus carinatum experience continued growth of the protrusion during growth spurts. Some children may experience shortness of breath, most often during exercise. The most common treatment for pectus carinatum is bracing therapy, though occasionally surgery is indicated. Timing of this treatment is important and is best during early adolescent and teenage years when cartilage is softer and the chest wall is more easily reshaped. We will help you to determine and carry out the right plan for your condition. Mixed Chest Deformity Mixed chest deformities may include a combination of pectus excavatum and pectus carinatum. We also see patients with pectus arcuatum. Pectus arcuatum is a rare chest wall deformity that causes the upper part of the sternum to protrude forward and the lower part to angle backward. Our surgeons will work with patients and families to create individualized treatment plans based on desired outcomes. Our Pectus Program The surgeons of Austin Pediatric Surgery have developed a multidisciplinary Chest Wall Program at Dell Children’s Medical Center. They specialize in treating structural deformities of the chest wall including pectus excavatum and pectus carinatum. The conditions are caused by an abnormal growth of the cartilage that connects the sternum to the ribs. Typically, pectus excavatum and pectus carinatum become more prominent during the rapid growth of early adolescent and teen years, but they can also develop at a much younger age. Sometimes there may be a family history of chest wall abnormalities, however these conditions can also be associated with certain connective tissue disorders, such as Marfan syndrome or Ehlers-Danlos syndrome. Our program will work with you and your family to make the best plan for your condition. If you have any questions, please contact our Chest Wall Program Coordinator at: dcchestwallprogram@ascension.org . Pectus Program Testimonials "My Daughter had her surgery with Dr.Josephs in June 2024 and it was a great experience from the start, I had so many questions answered and the staff were so amazing especially Sarah. I am grateful for the care and knowledge that I gained from this experience and for my daughters surgery to go so well! I couldn't thank Dr.Josephs enough for changing the course of my daughters life and making her life better! Forever grateful!" - Mother of patient with pectus excavatum "We had an exceptional experience with Dr. Grethel and his team, and I wanted to share our journey in the hopes it might help others. My 16 year old son Matt had been struggling with his stamina since the indent in his chest started worsening with puberty. He would often feel short of breath quickly, experience premature muscle burn during exercise, and describe the air as feeling “heavy.” After a couple of years of observation and consultation with Dr. Grethel, we felt that the NUSS procedure was the best solution for him. From the very beginning, Dr. Grethel and his team were incredibly professional, helpful, and supportive. They guided us through every step of the process, including navigating the complexities of insurance approval. Their patience and dedication gave us the confidence we needed during the uncertain times leading to surgery. The results have been incredible. Just a few days after the surgery, Matt noticed an immediate difference—he could breathe more easily, even at rest, which he had never realized was a challenge for in a little over six weeks, he was back to running, swimming, rowing, and lifting weights. We are almost 3 months post-op and the improvement in his stamina has been noticeable. We cannot thank Dr. Grethel and his staff enough for their outstanding care and support throughout this journey. We are so grateful for the positive impact this surgery has had on Matt’s life and highly recommend Dr. Grethel and his team." -Valerie L. "No one likes to have to send their child into surgery. No one likes to see the effects of pectus excavatum on their child's physical and emotional health. But the Nuss Procedure performed at Dell Children's hospital changed our child's life forever. The staff guided us through the preparation process, answering all of our questions and scheduling the requisite tests. The procedure involved a minimally invasive surgery whereby a titanium bar was inserted under the ribs, causing almost instant improvement. Because of advances in the procedure, the surgeons do a cryo-ablation of the nerves inside the chest wall, which thaw after 8 weeks. This means the patient is home sooner (two to three days instead of a week or longer in the hospital) and no prescription painkillers are necessary during recovery. It took three months to be completely able to do everything but because of the surgery, he feels more confident, healthier and happier." - Mother of patient with pectus excavatum "Prior to the surgery, I had a sunken sternum, and I had less breathing capacity. I had shortness of breath many times and I felt rather insecure about myself. However, when I went under the surgery, where they placed a metal bar under my sternum and pushed it up, results were almost instant. Following the surgery, I had more breathing room, allowing me to do activities more efficiently and not get as tired. I felt I could do more, and while recovery took time and adjusting, I felt more secure about myself. Now, I am happy with my chest and the results from the surgery, as I can do the activities I love and not get as short of breath!" - Patient with pectus excavatum

Austin Pediatric Surgery specializes in minimally invasive hernia procedures, including inguinal, umbilical and epigastric hernias. Quicker recovery and less pain for your child. Hernias UMBILICAL INGUINAL EPIGASTRIC OUR HERNIA PROGRAM Umbilical Hernia What is an Umbilical Hernia? An umbilical hernia is a bulge near the belly button caused by an opening in the abdominal wall that didn’t close fully during development. It’s most noticeable when a child cries or strains but typically isn’t painful. Most umbilical hernias resolve by age 4-5 years. Surgical closure may be needed if the hernia is still present beyond that age or if the child has symptoms. Evaluation and Diagnosis A pediatric surgeon confirms the diagnosis through a physical exam. Extra tests like imaging are rarely needed. Treatment Surgery is recommended if the hernia doesn’t close by age 4-5 years. General anesthesia is required for the procedure. Most children can go home from the recovery room after the surgery. Follow-Up Care Recovery is straightforward, with minimal restrictions for 2-3 weeks. Follow-up visits ensure proper healing and monitor for rare recurrences. When to Call the Doctor Contact your surgeon for fever, signs of infection, or persistent pain. Seek urgent care for symptoms of incarceration, like severe pain or a firm, red bulge. Inguinal Hernia What is an Inguinal Hernia? An inguinal hernia appears as a bulge in the groin, sometimes extending to the scrotum in boys. It occurs when abdominal contents pass through a small hole in a layer of the abdominal wall in the groin area. This is something that babies are born with, however, sometimes they can take time to diagnose. These hernias don’t resolve on their own and require surgical repair after the diagnosis is made. Evaluation and Diagnosis Diagnosis is based on the history of a groin bulge and physical examination. Ultrasounds are sometimes used to help confirm the diagnosis, but are not necessary. Treatment Surgical repair closes the hole or defect using stitches. Inguinal hernias in children are different from inguinal hernias in adults, so typically mesh is not required for the closure. Surgery requires general anesthesia and, depending on the age of the baby, can often be done as an outpatient procedure. Follow-Up Care Children recover quickly, with minimal discomfort managed by over-the-counter medication. Follow-up appointments check for healing and rare recurrences. When to Call the Doctor Contact your surgeon for fever, signs of infection, or persistent pain. Seek urgent care for symptoms of incarceration, like severe pain or a firm, red bulge. Epigastric Hernia What is an Epigastric Hernia? An epigastric hernia is an opening in the abdominal wall above the belly button. These hernias don’t close on their own. They often do not have symptoms, however sometimes can cause pain. Evaluation and Diagnosis Epigastric hernias are typically identified during physical exams, especially when a child stretches or arches their back. Treatment Surgical repair closes the opening with stitches. General anesthesia is required for the procedure and most kids go home from the recovery room after surgery. Follow-Up Care Children recover quickly, with minimal discomfort managed by over-the-counter medication. Follow-up appointments check for healing. When to Call the Doctor Contact your surgeon for fever, signs of infection, or persistent pain. Seek urgent care for symptoms of incarceration, like severe pain or a firm, red bulge. Other Hernias Our surgeons are experts in repairing all types of abdominal wall hernias, including parastomal and ventral hernias. For questions, call us at (512) 708-1234. Congenital Diaphragmatic Hernia Program Congenital Diaphragmatic Hernia (CDH) is a problem that babies are born with in which a portion of the diaphragm has not formed correctly. The diaphragm is the muscle that separates the abdominal cavity from the chest cavity to help you breathe. When a CDH occurs, the intestines, liver and other organs push up into the chest and prevent the normal development of the lungs. The lungs are smaller than they should be and the blood vessels in the lungs also don’t work well, frequently preventing blood to flow like it should through the lungs. This is called pulmonary hypertension. There are a number of tests and measurements that can be done as a fetus to assess the severity of the diaphragmatic problem. Babies born with CDH can be very sick soon after birth and may need to go on a heart lung bypass machine known as extracorporeal membrane oxygenation, or ECMO. Usually the surgery to repair the CDH is done in the first days or weeks of life. Depending on how much of the diaphragm is absent, the repair may include placing a patch of synthetic material where the diaphragm should be. Babies with CDH are often in the hospital for a long time after birth but we are there every step of the way with you, your baby, and your family to help make it as easy as possible. We are also there to follow up with you after you go home from the hospital. We will see your baby regularly and are always available as a resource for questions or concerns. Austin Pediatric Surgery leads a multidisciplinary team of maternal fetal medicine doctors, neonatologists, pediatric intensive care doctors, ECMO specialists, cardiologists, pulmonoligist and other doctors to take care of babies with CDH. We use the most up to date techniques and equipment to take care of these babies. If you have any questions about the CDH program, please contact us at Austin Pediatric Surgery. What is it? A hole in the diaphragm (muscle that helps you breath), which allows abdominal organs to move into the chest, impacting lung development. Treatment Surgery to repair the hole in the diaphragm to keep the abdominal organs out of the chest. Some babies with CDH can be very sick when they are born and require heart and lung bypass with ECMO. Follow-Up Long-term care for breathing, feeding, and developmental challenges.

Austin Pediatric Surgery treats Crohn’s disease, ulcerative colitis and IBD with specialized surgical care designed for children’s unique needs. Inflammatory Bowel Disease CROHN’S DISEASE ULCERATIVE COLITIS IBD UNSPECIFIED Inflammatory bowel disease (IBD) is an immune mediated inflammation of the intestines which can afflict pediatric patients. Although most IBD in children is treated with medicines, some children require surgical care for complex disease. The team at Austin Pediatric Surgery is committed to the care of children with IBD. We offer advanced treatments using minimally invasive techniques, such as laparoscopic ileocecectomy and colectomy with ileoanal pouch reconstruction. We work as a team with gastroenterologist to ensure you and your children receive the best multidisciplinary care we can provide. Dr. Jessica Naiditch is a board certified pediatric surgeon who has a special interest in IBD and leads the surgical IBD team at APS. Crohn’s Disease What is it? Crohn’s Disease causes inflammation in the gastrointestinal tract and can affect any portion of the intestines. It can result in strictures, fistulas, or blockages in the bowel. Signs and Symptoms Abdominal pain, fatigue, weight loss Persistent diarrhea or rectal bleeding Mouth ulcers or skin infections Possible effects on the liver, kidneys, and joints Evaluation and Diagnosis Diagnosis involves stool and blood tests, imaging (MRI/CT scans), and endoscopy with biopsies to confirm inflammation and disease extent. Treatment Medications: Steroids, immunomodulators, or biologics Surgery: Reserved for complications like bowel narrowing or fistulas, focusing on preserving intestinal length Follow-Up Care Ongoing gastroenterology follow-ups with nutritional and surgical monitoring are essential to maintain growth and minimize symptoms. Ulcerative Colitis (UC) What is it? UC is an inflammatory condition affecting the colon (large intestine)’s inner lining, causing pain, diarrhea, and bloody stool. Unlike Crohn’s, UC is limited to the colon and rectum. Signs and Symptoms Abdominal pain, weight loss, bloody diarrhea Symptoms outside the intestine, such as joint or skin issues Evaluation and Diagnosis Similar to Crohn’s, diagnosis requires bloodwork, imaging, and colonoscopy with biopsies to assess inflammation and disease progression. Treatment Medications: Similar to Crohn’s Surgery: Removal of the colon with reconstruction of the intestinal pathway (ileoanal pull-through procedure) can be curative Follow-Up Care Close monitoring with both surgical and gastroenterology teams ensures proper healing and growth. IBD Unspecified (IBDU) What is it? IBDU is diagnosed when symptoms overlap between Crohn’s and UC. It is more common in children and often requires less medical treatment. Treatment and Follow-Up Managed similarly to other IBD types, with an emphasis on monitoring symptoms and minimizing interventions. At Austin Pediatric Surgery, we are committed to helping your child manage IBD with expert care, whether through advanced medical treatments or surgery. Contact us for compassionate guidance tailored to your child’s needs.