Procedures of Limited Value Form | South Thames Paediatric Network

Surgery in Children

Procedures of Limited Value

Name of Trust

Operation:

Clinical reason for circumcision < 5 years

Clincial reason for umbilical hernia repair < 3 years

Clinical reason for Hydrocele Repair < 3 years

Clinical reason for Tongue Tie release under GA only

Please explain your "other" reason in the box below:

Date of operation:

Name of Surgeon: