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In addition to providing multidisciplinary care for patients of all ages who suffer this condition, the objectives of Vall d’Hebron Hospital’s Hereditary Angioedema Unit include teaching and research in this field.
The Hereditary Angioedema Unit (UAEH) of Vall d’Hebron University Hospital’s Allergology Department has been treating patients with this disorder for more than 25 years.
UAEH outpatients are treated by allergology specialists in a multidisciplinary manner in the Outpatient Clinic in the Old Nursing School and in the Children’s and Women’s Hospital, ensuring transference and continuity of care from childhood through to adulthood for this genetic, lifelong condition.
The Unit is made up of popular, immunologists, geneticists, gynaecologists, maxillofacial surgeons, pharmacists and nurses, who are responsible for:
Depending on the type of care to be given to patients with diagnosed hereditary angioedema and their profile, they should be treated by the following divisions and/or units:
The specialists who work in the adult and paediatric allergology sections are responsible for treating patients aged 16 and under in the Children’s Hospital areas and subsequently facilitating their transfer and continuity of care with monitoring to the adult care departments in the Old Nursing School and the Allergology Day Hospital in the General Hospital.
The Hereditary Angioedema Unit (UAEH) offers an outpatient service to monitor patients with this disease: the Outpatient Clinic on the second floor of the Old Nursing School. Also, as it is a multidisciplinary unit, and depending on the type of patient (child, adult, pregnant woman), it provides care in a number of departments and units in the Children’s and Women’s Hospital, the General Hospital and A&E.
The nursing team specialises in education and specific care for patients with this disease.
Emergency care is provided at the Children’s Hospital for patients up to the age of 16 and at the General Hospital from the age of 17. The professionals who work in the A&Es have been trained to recognise the symptoms of this disease and to quickly provide its specific treatment.
When a patient needs a complex dental or maxillofacial procedure they will be assessed by the hospital’s maxillofacial surgeons and their operation will be organised with the suitable prophylaxis.
The Obstetrics, Foetal Medicine and Anaesthesia Departments have created a Working Unit for High-Risk Pregnancies for women with hereditary angioedema with the aim of monitoring the well-being of mother and child during pregnancy and of providing care during the delivery and postpartum period in accordance with a protocol specific to their type of hereditary angioedema and clinical situation. Care is also provided for high-risk postpartum cases.
In parallel to these services, there is also a reproductive counselling clinic for women with hereditary angioedema. The clinic is part of the Hereditary Angioedema Unit, and is that provided in conjunction with Gynaecology in the Outpatient Clinics of the Children’s and Women’s Hospital.
In this clinic an allergist and a gynaecologist combine their expertise to determine, in accordance with the patient’s clinical situation and type of hereditary angioedema, the possible effects of their having children. Their mission is to provide information and advice in relation to family planning and the reproductive possibilities of the patients living with this disease.
The Oral and Maxillofacial Surgery specialty is defined as "the medical and surgical specialty dealing with the prevention, study, diagnosis, treatment and rehabilitation of the oral cavity and face, as well as the cervical structures that are directly or indirectly related to them".
The care provided at the Oral and Maxillofacial Surgery Department at the Vall d'Hebron University Hospital covers the following areas: outpatient visits, surgery, hospitalisation and accident and emergency services. Our Department is the only one in Catalonia with a 24-hour on-call system. This means we are a leading player in the Catalan public network.
We are also pioneers in innovation: in 2014, the Oral and Maxillofacial Surgery Department became the first in Catalonia to use computer-assisted surgery in its operations. This paradigm shift in surgical practice is based on collaboration between medical professionals from the Oral and Maxillofacial Surgery, Medical Oncology, Radiation Oncology, Radiology and Anatomy Departments.
Computer-assisted surgery, which incorporates an intra-operative browser similar to a GPS device, offers a three-dimensional, real-time vision of the position of the instruments. This guarantees greater reliability and accuracy.
Furthermore, improvements in scanning and 3D imaging mean we can perform virtual simulations of any surgery thanks to what is known as "pre-operative virtual planning", as well as the aesthetic result of the operation, with Morphing 3D.
Since 2016, we have been pioneers in incorporating a technology platform to allow collaboration between medical professionals and engineers and technicians designing prostheses. This new tool improves patient recovery and allows surgeons to prepare for operations. It also creates a point of contact from the very outset with the engineers and technicians who work on personalised prostheses for each patient. A model of networking between several Hospital departments.
We offer highly specialised care through multidisciplinary units for the treatment of complex pathologies, such as maxillofacial oncology and microsurgical reconstruction of the base of the skull and salivary glands.
We are a group of highly qualified professionals in a cohesive, motivated team that handles the complex pathologies handled only by tertiary centres. These professionals are further renowned for their activity and participation in scientific societies.
All this guarantees more precise surgery that takes fewer hours and entails less risk for the patient. The next step is to design new biocompatible tissue, a line of research that the Vall d'Hebron Research Institute (VHIR) is already working hard to advance. The New Technologies and Craniofacial Microsurgery group of the Centre for Research in Biochemistry and Molecular Biology for Nanomedicine (CIBBIM) will study the application of new biomaterials in facial reconstructive surgery, cellular therapies with stem cells in the field of biomaterials, oncology and the use of new devices and biomarkers for early diagnosis in oral cancer.
Our Department is also involved in teaching at all levels: undergraduate, postgraduate and continuing education, as well as research activity. These areas are a fundamental part of our activity.
The Teaching Unit is led by the Oral and Maxillofacial Surgery Department, with participation from other specialisations such as General Surgery, Vascular Surgery, and the Traumatology Intensive Care Unit.
Oral and maxillofacial surgery training itinerary
Why specialise at Vall d’Hebron?
In 10,000 square metres there are 19 operating theatres designed to carry out highly complex operations. Operational since late 2016, this project forms part of our strategy to progressively adapt our spaces.
For patients, this technology means less aggressive surgery can be conducted, facilitating postoperative care and shortening the length of time for which they are hospitalised.
The Surgical Block, opened in September 2016, represents a technological and quality breakthrough for both patients, focusing on reducing surgery and postoperative care times and for professionals, incorporating new surgical techniques and making their work more precise. In addition, the Surgical Block has a clear orientation towards sustainability and energy efficiency. The new facilities, the leading technology and the change of management through processes allow new surgical techniques to be carried out, improving patient security and the work of professionals.
Operating theatres incorporate neurosurgery navigation systems, 3D imaging systems, integrated ultrasound and the new Da Vinci Xi robot. With this incorporation, Vall d'Hebron University Hospital is the first in Spain to have two operating theatres equipped with Da Vinci® robotic technology for clinical use. In addition, it has two hybrid operating theatres. They incorporate X-ray surgical arches to be able to see surgery results directly, designed for vascular surgery and neurosurgery.
The design of operating rooms is optimised in space and time. Among other improvements, we can configure the operating room according to the type of surgery. In just a few seconds, it adjusts to the predetermined position. All the necessary devices and connection points hang from the ceiling through an electronic tower system, making the space more accessible and easier to prepare for the next operation. At the same time, it allows for a more sustainable energy management.
The General Hospital Surgical Block has a total of 700 professionals, with the aim of maintaining and improving the figure of almost 8,000 operations a year in this field alone.
To help achieve these goals, professionals have seen a series of improvements in work processes thanks to these new facilities and the incorporation of technology. For example, to facilitate the distribution of material, we use a 1,000 m2 robotic system which distributes all the material needed for each operation.
Aside from operating rooms, the Block includes two rooms for patient care before and after undergoing surgery. The Pre- and Post-Anaesthetic Recovery Unit (URPA) aims to optimise the use of the operating theatre, since previously patients would go to sleep and wake up in the operating room. In addition, anaesthesia and nursing staff work in the URPA, and the Unit is clearly orientated to better and safer patient care.
The new General Hospital Surgical Block, as well as its organisational management, has been developed with the participation of a multidisciplinary team made up of professionals from all fields. It is an example of participation and teamwork, in which voices have been collected to develop healthcare projects focused on innovation and the improvement of clinical management. This project required an investment of €21 million in construction and €16 million more in equipment.
Maxillofacial and Oral Surgery, General Hospital
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