Anaesthesia for specialist surgery in infancy

Specialist surgery in infancy provides unique and significant challenges for paediatric anaesthetists. Both common (inguinal hernias and hypertrophic pyloric stenosis) and less common conditions (tracheo-oesophageal fistula, congenital diaphragmatic hernia, exomphalos (omphalocele), gastroschisis and congenital lobar emphysema) require a sound understanding of the relevant pathology and the particular issues that may be encountered in order to safely anaesthetise these infants. It is important to maintain a high attention to detail and to strive for excellent communication between all members of the perioperative team. In the last decade there has been a rise in the number of procedures in infancy being performed with a minimally invasive technique and this has a wide range of implications for anaesthesia.