They cannot always say what’s bothering them. They cannot always answer medical questions. They are not always patient during a medical examination.

Children are definitely not small adults. They behave differently and treating them often means different tests and techniques.

The more you talk with the UNLV Medicine pediatric surgery team — Drs. Michael Scheidler, Stephanie Jones and Shirong “Sara” Chang — and the more you research their specialty, the more you realize just how important it is for children to have access to pediatric surgeons who diagnose, treat, and manage children’s surgical needs, including:

• Surgical repair of birth defects
• Serious injuries requiring surgery
• Surgical care of tumors
• Weight-loss (bariatric) surgery
• Chest wall deformities
• Endoscopic procedures (bronchoscopy, colonoscopy, esophagogastroduodenoscopy)
• Surgery for abnormalities of the groin in childhood and adolescence, which include undescended testes, hernias, hydroceles (swellings in the scrotum) and varicoceles (when veins become enlarged inside the scrotum, which can impact fertility)

Scheidler, Jones and Chang comprise the only academic pediatric surgery practice in Las Vegas, meaning they’re connected with a medical school where both research and teaching are expected. They teach general surgeons and are always pleased when a resident decides to pursue a fellowship in pediatric surgery. The trio has also published research in distinguished journals that include the Journal of Pediatric Gastroenterology and Nutrition, Journal of Pediatric Surgery, and Journal of Laparoendoscopic and Advanced Surgical Techniques.

Scheidler points out that the UNLV pediatric surgical unit is one of the first on the West Coast to move beyond traditional laparoscopic surgery to provide robotic-assisted laparoscopic surgery for children. That can mean a decreased length of stay in the hospital.

Better Outcomes

While many children still receive surgical care from adult specialists, the research, as reported by the American Academy of Pediatrics, is clear: Children treated by pediatric surgeons have better outcomes than those treated by adult specialists.

According to Scheidler, who is board-certified in both pediatric surgery and pediatric trauma surgery, a five-year residency in general surgery, followed by a two-year fellowship in pediatric surgery, better prepares a surgeon to handle children from the newborn stage through late adolescence. There are fewer than 700 board-certified pediatric surgeons practicing in the nation.

Scheidler, the father of two children, loves working with pediatric patients.

“They’re so innocent. They just want to play. They look at you, want to know why they’re sick. They didn’t do anything wrong, but don’t feel good. It compels you to make them feel better,” he said.

Jones recalled being operating on a premature baby born at 23 weeks. “The child needed multiple operations — had a lot of problems,” she recalled. “Now the child is growing and thriving. I still get birthday cards from the family showing how well the child is doing. It was an honor to help the child and the family. I feel very privileged to do this work.”

Like Scheidler, she is excited about the recently established pediatric bariatric surgery program. Studies show 35 percent of Nevada’s adolescents are overweight or obese and projections show that by 2030, 50 percent will be obese and 85 percent overweight.

“The program is important for this population,” she said, noting that problems like diabetes and hypertension may be solved through bariatric surgery. She added that processed foods, coupled with a lack of exercise, have heavily contributed to the weight problem.

Scheidler says clinical psychologists and nutritionists are part of the bariatric program that could prolong a child’s life by as much as 20 years.

 “We have to be sure that the child is psychologically mature enough for this program.” he said, stressing no child under the age of 14 can have the surgery.

Robotic Surgery

Chang said she appreciates minimally invasive robotic surgery because it means a faster recovery for kids.

“It’s much easier to operate for a surgeon,” she said. “And it means less pain for a child.”

Not long ago, Chang had to perform a thyroidectomy — where all or part of the thyroid gland is removed — on a child with thyroid cancer. “That child is now cancer free,” she said. 

Chang, who once operated on a child who weighed only 450 grams, said pediatric surgery requires intense focus and concentration. “You must handle tissue more gently as a pediatric surgeon,” she says.

She said she can think of nothing she’d rather do professionally than help children get well.

“I don’t think there can be anything more rewarding.”

(UNLV pediatric surgery is located at 3121 S. Maryland Parkway, Suite 400. To make an appointment, call 702-650-2500.)