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Thirty weeks low-birth-weight preterm COVID-positive baby with anorectal malformation underwent emergency laparotomy in view of perforative peritonitis. Baby was assessed by a virtual telecommunication. Safety precautions were carried out for health-care workers during patient transit, aerosol-generating procedures, surgery, and postoperative care in COVID intensive care unit. Scarcity of evidence base for preterm neonates at that time made us design and efficiently conduct our own safety protocol. Interdepartmental team work was the key. [ABSTRACT FROM AUTHOR]

One percent babies are born with varying grades of obstructive uropathy. In less than half of them surgical intervention may be necessary at the right time to protect the kidney from deterioration. Bilateral obstruction is commonly due to infravesical obstruction secondary to lesions at bladder outlet or urethra i.e., posterior urethral valves in boys and uretrocoele in girls. Majority of them are symptomatic and may require intervention in the neonatal age. The corner stone of diagnosis is a well performed micturating cystourethrogram. Endoscopic procedure under direct vision and videorecording can take care of the vast majority of the lower urinary tract lesions in newborns. The commonest aetology of upper urinary tract obstruction are pelviuretric junction obstruction and vesicoureteric junction obstruction. A pelvic diameter of more than 15 mm and ureteric diameter more than 10 mm are significant dilatation and requires serious attention. The low GFR of a newborn kidney does not allow the functional imaging to be very reliable. Accurate and serial measurement of the pelvic dilatation along with drainage studies with isotope renogram can allow an reliable assessment by one month. In a small percentage, intervention may be necessary as early as the first month. [Copyright &y& Elsevier]

Minimal Access Surgery (MAS) in children is relatively a new area. This technique of surgery has been validated in children for common operation than appendicectomy, nephrectomy, cholecystectomy etc. These are being regularly done at Apollo Hospitals and our experience is being presented. The use of MAS for reconstructive procedure is at a developmental stage and not yet widely evaluated over long term. [Copyright &y& Elsevier]

The wider availability of antenatal ultrasound in the community is leading to an every increasing antenatal diagnosis of urological anomalies. The serial monitoring of the urinary tract in the affected babies in the intrauterine life provides important clue to the correct diagnosis. The antenatal management is limited to serial 4 weekly follow up, unless bilateral urinary tract is affected. Antenatal intervention remains at an experimental stage without significant documented benefit demonstrable. The most exciting area of experimental fetal urology is fetal cystoscopic ablation of posterior urethral valves. The postnatal management of these antenatally diagnosed anomalies has essentially remained unchanged. However, antenatal diagnosis does allow early accurate diagnosis and selective intervention prior to appearance of symptoms, infectious complications or further loss of renal function. [Copyright &y& Elsevier]

1:3500 babies are born with major life threatening gastrointestinal anomalies which may present at any stage from birth to much later on in life. In the last 24 months more than 100 consecutive major gastrointestinal reconstructive surgeries have been done in newborns, infants and young children at Apollo Hospitals, New Delhi. These babies have been followed at regular intervals for the anatomical and functional outcome in the intermediate term (3 mo-24 mo) More than ninety percent of operated babies are growing and thriving without any symptoms. The category with highest failure rate remains biliary atresia, where portoenterostomy has limited success rate not exceeding 25% in our hands. However the overall anatomical and functional results in babies who have undergone major gastrointestinal reconstruction is very encouraging and exceeds 90%. [Copyright &y& Elsevier]