Paediatric Oncological Surgery Unit

Paediatric oncological surgery is the branch of paediatric surgery that is dedicated to the surgical treatment of paediatric oncological and haematological diseases and their complications. It is one of the basic pillars for the treatment of solid paediatric tumours.

These are illnesses that, due to their severity, complexity, and rareness, must be centralised in hospitals that are equipped with experienced multidisciplinary teams and the technology and medical experience necessary. The evolution of this unit has often gone hand-in-hand with the surgical advances achieved in solid organ transplants, which has allowed it to develop advanced techniques that now make enormously difficult cases operable. In addition, it frequently requires collaboration from other highly complex paediatric specialities (heart surgery, neurosurgery, spinal surgery, plastic surgery, etc.).

Vall d’Hebron is the hospital that offers the most oncology services in Catalonia, and it is a member of the European Reference Networks (ERNs) for Paediatric Oncology “PaedCan” and Rare Haematological Diseases “EuroBloodNet”. It is also accredited by JACIE for paediatric haematopoietic stem cell transplants.

The Paediatric Oncological Surgery Unit service has the accreditation
Authorship: Vall d'Hebron
Creation date: 17.12.2021, 10:03
Modification date: 30.06.2020, 12:27
Share it
Did you find this helpful?

Paediatric Surgery

Paediatric surgery is the only medical speciality exclusively dedicated to diagnosis, treatment, and post-operative care for problems which occur during the life stage between the foetal period and adolescence and which need to be treated surgically. The surgical pathologies, physiology, doctor-patient relationship, and needs of the paediatric patient are very different from those of an adult. Due to the complexity of the pathologies treated and the special needs of the paediatric patient, this type of surgery is usually restricted to tertiary centres.

Thanks to the wide range of pathologies we treat, the paediatric surgeons here receive training on how to carry out procedures in almost all surgical areas. Working closely with obstetricians, the paediatric surgeons participate in detecting and treating pathologies that are diagnosed in utero, providing prenatal medical advice to families, and even carrying out surgeries on foetuses or during labour.

The specialists in paediatric surgery receive specific training on how to correct congenital abdominal, thoracic, and urological defects, some of which can potentially be fatal. We also provide care for patients who are multiple trauma victims and those who need surgical treatment for solid tumours. We are also the specialists who treat the urological and gynaecological problems that occur in this age range.

The Paediatric Surgery service has the accreditation
Authorship: Vall d'Hebron
Creation date: 17.12.2021, 10:03
Modification date: 30.06.2020, 12:25
Share it
Did you find this helpful?

Neonatal and Foetal Surgery

Neonatal Surgery is the sub-discipline within paediatric surgery that deals with surgically treating congenital and acquired illnesses in newborns and infants up to one month old.

This is a highly complex sub-speciality that only exists at tertiary paediatric centres. The past few decades have brought about important advances, thanks to improvements in diagnostic techniques, neonatal intensive care and anaesthetics, and surgical techniques and materials. These have radically changed the prognosis for both birth defects and acquired surgical pathologies in newborns.

The Neonatal and Foetal Surgery service has the accreditation
Authorship: Vall d'Hebron
Creation date: 17.12.2021, 10:03
Modification date: 08.06.2020, 10:47
Share it
Did you find this helpful?

Paediatric Surgery

The Paediatric Surgery Department at Vall d’Hebron University Hospital is a reference in Catalonia for the treatment of most paediatric surgical problems and in the rest of Spain for specific procedures. Our mission is to care for paediatric patients with surgical concerns.

Accredited places

2

Research groups
Document

Pediatric Surgery Training Itinerary

Contact with the teaching unit

Paediatric Surgery is a discipline that covers a wide range of pathologies, from congenital, acquired, malformation, infectious and tumoral conditions, including thoracic, abdominal and genitourinary issues.

Our involvement in patient care spans from before birth (foetus, prenatal period) through to late adolescence.

To provide the highest quality, our service is structured into different subspecialities:

  • Neonatal Surgery
  • Oncological Surgery
  • Digestive Surgery
  • Thoracic Surgery
  • Hepato-bilio-pancreatic surgery
  • Urology

This innovative structure allows us to achieve a high level of super-specialisation and expertise in a specific area of modern paediatric surgery, which further benefits our paediatric patients and ensures a higher quality of care.

Our Paediatric Surgery department was the first in Spain to introduce a Foetal Surgery Programme, forming part of the multidisciplinary Foetal Medicine programme.

Similarly, we were the first hospital in Spain to perform paediatric transplants, kidney transplants from 1981 and liver transplants from 1985, including being the first to carry out a reduced liver transplant in 1987 and the first ‘split’ liver transplant in 1992. Our Hospital and our Department remain directly involved in the liver and kidney transplant programmes, which are among the highest volume and best-performing in the country.

We are committed to high-complexity surgery, introducing increasingly minimally invasive techniques to various paediatric-age groups, including neonatal surgery, and even venturing into foetal surgery. Among these minimally invasive techniques, we incorporate robotic surgery. Starting in 2009, we were the first paediatric hospital in the country to develop a robotic surgery programme.

Our department is currently accredited by various national and international benchmarking programmes: CSUR (Centres, Services and Units of Reference of the Ministry of Health) for Neuroblastomas, Childhood Sarcomas, Paediatric Liver Transplant, Paediatric Kidney Transplant, Bladder Exstrophy and Epispadias.

We are also ‘Full-Members’ of various ERN (European Reference Networks) such as ERNICA and EUROGEN, as well as Paediatric Oncology and Erythropathies.

Training at Our Department

In 2012, we received the Certificate of Hospital Accreditation for Specialist Training in Paediatric Surgery from the European Board of Paediatric Surgeons, with the endorsement of the UEMS, as a centre of excellence for the training of paediatric surgeons and in 2023, we were again re-accredited as a Centre for Training in Paediatric Surgery.

Our programme allows residents to gain comprehensive training in all areas of paediatric surgery, which, unlike programmes at other centres, encompasses everything from organ transplants to foetal surgery, including neonatal, oncological, thoracic, digestive and urological surgeries. Training emphasises the most advanced minimally invasive techniques, including robotic surgery. Our simulation laboratory for minimally invasive surgery enables our residents to train in an appropriate and safe environment.

During the first semester, residents undergo adult general and thoracic surgery training. Subsequently, they join our department, rotating through the various subspecialities according to their training programme. During on-call shifts (4-5 per month), the resident is accompanied by a senior doctor who is physically present. During continuous care, paediatric surgical emergencies are covered, and they participate in the paediatric polytrauma care programme. During these shifts, we encourage the resident’s autonomy in surgical decision-making and their proficiency executing the various surgical techniques performed. Furthermore, residents are integrated into paediatric transplant programmes (liver and kidney).

The training pathway for residents in our centre ensures learning across all paediatric surgical subspecialities, encompassing everything from outpatient surgeries to highly complex surgeries such as intricate oncological surgeries, complex anorectal malformations and solid organ transplants. Additionally, there is a six-month period where optional rotations can be undertaken, where the resident can choose from options available in our centre including: paediatric plastic surgery, paediatric cardiovascular surgery, paediatric neurosurgery, paediatric anaesthesia, paediatric maxillofacial surgery.

Continued training sessions are held between members of the department and external specialists:

  • Morbidity and mortality session
  • Clinical case session
  • Surgical techniques session
  • Pathological anatomy session
  • Literature review session
  • Resident session
  • Weekly surgical planning sessions
  • International staff session

During the final year of training, a rotation to international centres of excellence is encouraged. Throughout the residency, clinical and laboratory research is promoted, encouraging the presentation of papers at national and international conferences and publications.

Furthermore, training courses deemed necessary for the speciality are provided during the residency:

  • Basic and Advanced Paediatric Resuscitation Course
  • Initial Care for Paediatric Trauma
  • Simulation in Minimally Invasive Technical Skills

Throughout rotations in various units, the relevant team provides information on courses and subspecialist conferences that are more appropriate to attend and/or submit papers. There are also specific courses which, depending on the resident’s interest, can be optional or mandatory.

In the field of research, residents are encouraged to participate in the department’s active research initiatives and new research that may or may not be related to these research lines and which may result in the pursuit of a doctoral thesis.

Currently, at the Vall d’ Hebron Research Institute (VHIR) we maintain several established paediatric research lines in experimental surgery, specifically focusing on foetal surgery. In 2015 we created the Bioengineering group, Cellular Therapies and Surgery in Congenital Malformations, which is currently researching prenatal treatment of spina bifida and congenital diaphragmatic hernia. Moreover, among other projects, we have conducted research on amniotic band syndrome, gastroschisis, oesophageal atresia and bladder augmentations. These translational research programmes have enabled patients to benefit from them, notably the FETO techniques (foetal tracheal occlusion in the serious congenital diaphragmatic hernia) and the prenatal repair of the myelomeningocele, initially by open surgery and since 2015 via fetoscopic methods.

Regarding clinical research, the first multicentre randomised controlled trial on the treatment of parapneumonic empyema stands out, comparing video-assisted thoracoscopy to drainage and use of fibrinolytics, subsequently published in the journal Pediatrics. Additionally, there are numerous clinical research lines across all units, with publications in national and international journals.

At the same time, we collaborate with other research teams, particularly in the field of paediatric oncology, as well as in collaborative studies and international multicentre studies. Experimental research groups:

  • CIBBIM Bioengineering, Cellular Therapies, and Surgery for Congenital Malformations (VHIR)
  • Translational Research Group in Childhood and Adolescence Cancer (VHIR)

Why should I specialise at Vall d’Hebron?

  • Because we have received the Certificate of Hospital Accreditation for Specialist Training in Paediatric Surgery, which certifies us as a European centre of excellence for resident training.
  • Because we offer tertiary-level training in all areas of paediatric surgery, including solid organ transplants and foetal surgery.
  • Because we are committed to minimally invasive surgery, encompassing the only paediatric robotic surgery programme in the country and the most advanced techniques for neonatal patients.
  • Because every week, we hold surgical programming sessions to discuss the most complex cases, continuous training sessions to keep up with the latest knowledge, morbimortality and surgical technique sessions.
  • Because we are pioneers in paediatric transplants in Spain, having performed the first paediatric kidney transplant (1981) and the first paediatric liver transplant (1985).
  • Because in 2001, we created the first foetal surgery programme in Spain, and we were the first to undertake prenatal treatment of severe diaphragmatic hernia and the fetoscopic treatment of myelomeningocele.
  • Because paediatric oncology and oncological surgery at Vall d’ Hebron Hospital are nationally and internationally renowned, treating the largest number of patients in Spain, and handling the most complex tumours.
  • Because, with the expertise of specialists, we have integrated the most advanced techniques in treating thoracic wall malformations.
  • Because we are the leading centre for paediatric hepatobiliary and pancreatic surgery.
  • Because we organise national and international courses in areas of excellence.

Bioengineering, cell therapy and surgery in congenital anomalies

David Usó Bou

David Usó Bou

Paediatric Surgery, Children's Hospital and Woman's Hospital

Francisco Javier Bueno Recio

Francisco Javier Bueno Recio

Paediatric Surgery, Children's Hospital and Woman's Hospital

Subscribe to our newsletters and be a part of Vall d'Hebron Campus

By accepting these conditions, you are agreeing to the processing of your personal data for the provision of the services requested through this portal, and, if necessary, for any procedures required by the administrations or public bodies involved in this processing, and their subsequent inclusion in the aforementioned automated file. You may exercise your rights to access, rectification, cancellation or opposition by writing to web@vallhebron.cat, clearly stating the subject as "Exercising of Data Protection Rights".
Operated by: Vall d’Hebron University Hospital Foundation – Research Institute.
Purpose: Manage the user’s contact information.
Legitimisation: Express acceptance of the privacy policy.
Rights: To access, rectify, and delete personal information data, as well to the portability thereof and to limit and/or oppose their use.
Source: The interested party themselves.