Dr. Greeshma Suresh

Managing delicate surgical conditions in newborns requires exceptional precision and expertise. Dr. Greeshma Suresh is highly skilled in treating complex congenital anomalies with advanced surgical techniques. Her compassionate approach ensures improved outcomes and safer recovery for neonates.

Dr. Greeshma Suresh specializes in minimally invasive pediatric procedures that reduce pain, scarring, and hospital stay. Her expertise ensures faster recovery and enhanced patient comfort.

Early diagnosis and surgical correction are crucial for optimal outcomes in anorectal malformations. Dr. Greeshma Suresh brings extensive experience in performing precise corrective surgeries in children. She focuses on long-term functional outcomes and quality of life.

Dr. Greeshma Suresh is proficient in managing and surgically correcting TEF with a high success rate. Her expertise ensures safe intervention and improved survival in newborns.

Dr. Greeshma Suresh has vast experience in treating pediatric urological conditions such as undescended testes, hypospadias, and hydronephrosis. She delivers patient-centric care with excellent surgical outcomes.

Dr. Greeshma Suresh is skilled in performing safe and effective appendicectomy procedures in pediatric patients. Her approach focuses on timely intervention and quick recovery.

Hirschsprung disease is a congenital condition caused by the absence of nerve cells in a segment of the large bowel, producing functional obstruction, and requires surgical removal of the affected bowel segment with restoration of normal bowel continuity. Dr Greeshma Suresh provides expert diagnosis and surgical management of Hirschsprung disease at Vatsalya Children Hospital, Varanasi, including suction rectal biopsy for confirmation of diagnosis, definitive pull-through surgery to remove the aganglionic segment, and structured long-term follow-up to monitor bowel function and screen for enterocolitis. Her experience in neonatal and paediatric colorectal surgery, combined with her research publications on congenital gastrointestinal conditions, ensures evidence-based management tailored to each child's specific anatomy and clinical condition. Written by Dr Greeshma Suresh, MBBS (NEIGRIHMS), MS General Surgery (Silchar Medical College), MCh Pediatric Surgery (Institute of Medical Sciences, BHU, Varanasi), Paediatric Surgeon, Vatsalya Children Hospital, Mahavir Road, Orderly Bazar, Varanasi, Uttar Pradesh 221002.

Congenital diaphragmatic hernia (CDH) is a life-threatening neonatal condition in which a defect in the diaphragm allows abdominal organs to herniate into the chest cavity, compressing the developing lungs and producing respiratory failure at birth that requires urgent stabilisation and surgical repair. Dr Greeshma Suresh provides surgical repair of congenital diaphragmatic hernia at Vatsalya Children Hospital, Varanasi, as part of a multidisciplinary management approach involving neonatology, paediatric anaesthesia, and surgical teams. Surgical repair involves returning the herniated organs to the abdomen and closing the diaphragmatic defect, and is performed once the newborn has been stabilised on respiratory support. Her MCh training at BHU's Institute of Medical Sciences and her neonatal surgical experience equip her to manage this technically demanding and time-sensitive condition. Written by Dr Greeshma Suresh, MBBS (NEIGRIHMS), MS General Surgery (Silchar Medical College), MCh Pediatric Surgery (Institute of Medical Sciences, BHU, Varanasi), Paediatric Surgeon, Vatsalya Children Hospital, Mahavir Road, Orderly Bazar, Varanasi, Uttar Pradesh 221002.

Posterior urethral valves is a condition where the single most powerful determinant of long-term kidney outcome is the timing of diagnosis. The valve obstruction begins causing kidney damage in fetal life, during the critical months of renal development, and every day of untreated obstruction after birth adds to the kidney's burden. Antenatal diagnosis, now achievable through routine second-trimester ultrasound, gives the neonatal and paediatric surgical team the ability to be fully prepared at delivery and to begin treatment within hours of birth. The antenatal ultrasound features that raise the suspicion of PUV in a male fetus include a persistently dilated, thick-walled bladder that does not empty fully between scan images, bilateral hydronephrosis with dilated ureters, and oligohydramnios, a reduced volume of amniotic fluid caused by the fetus producing less urine than normal because the kidney damage has reduced their urinary output. Oligohydramnios in the context of renal obstruction carries its own additional risk to fetal lung development, because the fetal lungs develop by practising breathing movements in amniotic fluid, and severe or prolonged oligohydramnios can result in pulmonary hypoplasia alongside the renal problem. Dr. Greeshma Suresh, MCh Paediatric Surgery from the Institute of Medical Sciences, Banaras Hindu University, where her MCh research specifically investigated aldosterone and renin levels as prognostic biomarkers in PUV, manages PUV at Vatsalya Children Hospital, Varanasi with the combined understanding of the surgical anatomy and the deeper hormonal biology of what obstruction does to the developing kidney. In the delivery room or in the first hours of life, a urethral catheter is placed immediately in any newborn male with known or suspected PUV to drain the bladder acutely and relieve the outflow obstruction. This single intervention begins to reduce the back-pressure on the kidneys before any investigation or definitive treatment takes place. The definitive diagnostic procedure is the micturating cystourethrogram (MCUG), in which contrast dye is instilled into the bladder through the catheter and X-ray images are taken as the baby attempts to void. The MCUG demonstrates the characteristic appearance of a dilated posterior urethra with the impression of the obstructing valve, confirming the diagnosis. Renal ultrasound and blood tests for creatinine and electrolytes are performed simultaneously to establish the baseline of kidney function. The creatinine nadir, the lowest creatinine level reached in the first weeks after birth as the maternal creatinine gradually clears from the baby's bloodstream, is one of the most clinically important values in PUV management: it provides the best early estimate of the baby's own underlying kidney function, and it predicts long-term renal outcome better than the birth creatinine level alone.

Endoscopic valve ablation is the definitive surgical treatment for posterior urethral valves, and in newborns who are large enough for the cystoscope to pass safely through the urethra, it is the treatment of choice from the earliest days of life. The procedure requires no skin incision. A small cystoscope is passed through the urethra into the bladder under general anaesthesia, and the abnormal obstructing tissue of the posterior urethral valve is divided using a fine diathermy hook or cold knife passed through the instrument channel of the cystoscope. The division of the valve tissue immediately removes the obstruction to urinary outflow. The procedure takes approximately 20 to 30 minutes. A urethral catheter remains in place for one to two days after the ablation to allow the urethra to rest, and is then removed. The technical challenge of PUV ablation in the newborn period is the size of the urethra: it is a narrow structure in a newborn male, and the cystoscope must be small enough to pass through without damaging the urethral mucosa. In very small or premature newborns whose urethra is too narrow to accommodate even the smallest available paediatric cystoscope safely, the immediate endoscopic ablation is deferred. A temporary vesicostomy is performed instead: a small opening is created between the bladder and the skin of the lower abdomen, through which urine drains freely without having to pass through the obstructed urethra. The vesicostomy protects the kidneys from ongoing back-pressure while the baby grows to a size at which endoscopic ablation can be performed safely. Once ablation is complete, whether immediately or following a period with a vesicostomy, the urinary tracts are monitored with serial renal ultrasound scans to assess how the hydronephrosis resolves and how the bladder wall thickness changes. Kidney function is monitored regularly with blood tests. Dr. Greeshma Suresh is clear that parents need to understand the important distinction between what ablation achieves and what it cannot achieve. Endoscopic valve ablation removes the obstruction. It cannot reverse the developmental damage that the kidneys and bladder sustained during the months of fetal obstruction. Many boys with PUV have some degree of bladder dysfunction after successful ablation, because the bladder has spent months developing against a high-resistance obstruction and has acquired patterns of abnormal storage, reduced compliance, or incomplete emptying that do not automatically normalise when the obstruction is removed. Bladder function assessment, bladder training, anticholinergic medication, or intermittent catheterisation may be part of the long-term management plan. Some boys have significant residual renal impairment that requires ongoing nephrological care. The MCh research into aldosterone and renin as biomarkers of kidney hormonal adaptation in PUV informs the understanding of why some kidneys recover more function after ablation than others, and why continued surveillance of these hormonal markers alongside standard renal function tests provides a more complete picture of kidney health over time. At Vatsalya Children Hospital, Varanasi, every boy treated for PUV is enrolled in a structured long-term follow-up programme involving serial renal imaging, kidney function testing, bladder function assessment, and blood pressure monitoring, because the outcomes in this condition are determined as much by the quality of ongoing surveillance as by the quality of the initial surgery.