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In addition to the subspecialties that are traditionally related to the field, the Gynaecology Department at Vall d'Hebron University Hospital has for several years now also incorporated gynaecological endoscopic surgery: laparoscopy and hysteroscopy. These account for almost 50% of the scheduled operations performed by the Department and most of them are carried out as outpatients, in the day hospital.
This Unit carries out diagnosis, treatment and monitoring of benign gynaecological pathologies that require surgical treatment using laparoscopic treatment.
The Major Outpatient Surgery Unit is located on the 3rd floor of the Maternity and Children's Hospital, next to the three operating theatres where the Endoscopy Unit and Post-Surgical Resuscitation Division carry out most of their operations.
The surgical area on the 3rd floor is home to the day hospital for major outpatient surgery, with capacity for 6-7 patients in each surgical session. Activity is divided into: four weekly surgical sessions for laparoscopy and one for hysteroscopy. The hospitalisation area is located on the 9th floor of the Maternity and Children's Hospital, with clinics on the 4th floor, where we carry out three modules per week.
At the Pere Virgili Health Park, where we have an operating room, there is a fortnightly module for low-complexity outpatient surgery. Since June 2009, we also offer the possibility of robotic assistance using the Da Vinci system, for more complex endoscopic procedures.
The Endocrine, Metabolic and Bariatric Surgery Unit is part of the General Surgery Department and has two main purposes: on the one hand, we handle tasks related to endocrine surgery, and, on the other, we also handle metabolic and bariatric issues.
We offer excellence in care for thyroid surgery, and our clinical research and the use of the latest techniques, such as recurrent nerve monitoring and visual amplification of the surgical field, mean the care provided for this pathology guarantees the highest standards, both in benign and malignant pathology.
As for parathyroid pathology, we always try to use minimally invasive techniques.
Adrenal pathology is addressed primarily through laparoscopic surgery, and the Unit has acquired extensive experience over the years.
In the fields of bariatrics and metabolism, we perform all types of technique, both restrictive and malabsorptive and mixed techniques: gold standard, laparoscopic gastric bypass and vertical laparoscopy.
The introduction of robotic surgery at the Unit means we have become pioneers in robotic bariatric surgery, with the creation of a model of robotic surgical technique for gastric bypass and tubular gastroplasty.
Surgery is a fundamental pillar for patients diagnosed with morbid obesity living with health problems such as diabetes mellitus, hypertension, cardiocirculatory problems and respiratory disorders. The objective of bariatric surgery is twofold: on the one hand, to re-educate eating habits so that the maximum loss of excess weight can be achieved in the shortest amount of time possible in a sustainable way and, on the other hand, to prevent, reduce and treat obesity-related comorbidity.
Our arsenal of surgical techniques, such as gastric bypass and vertical gastrectomy, includes more complex techniques to alleviate the devastating effects of obesity on such patients. Likewise, in the last 15 years, developments in robotic surgery (where the surgeon operates on the patient through the use of a robot that responds to their orders, improving precision, vision and possibilities of movement) mean these techniques can be carried out more safely and have become more commonplace.
Vall d'Hebron University Hospital is a European reference centre in robotic surgery for obesity. In 2012, we were the first hospital in Spain to operate on the first adolescent patients with morbid obesity, and we are currently recognised as a centre of European excellence.
The joint work of bariatric surgeons and endocrinologists means the Unit is in a privileged position when it comes to metabolic surgery to treat diabetes, when appropriate.
The Section carries out its own research projects, collaborating with other hospitals and other Departments within our Hospital, further information about which can be found in the publications and research sections.
For teaching, our Section has two resident doctors who rotate periodically. We also train medical students from the Autonomous University of Barcelona in the surgical disciplines related to our Unit.
The Digestive Surgery and Transplant Department depends on the Paediatric Surgery Department and has pursued lines of work in the treatment of Hirschsprung's disease, anorectal malformations and treatment of short gut syndrome, and, in this last field, it is one of the most experienced centres in Spain in the "step" technique, among others.
Our Department stands out for our use of endoscopic and laparoscopic techniques, including robotic techniques, and for our treatment of complex hepatobiliary pathologies, with excellent results in the obstruction of bile ducts, hepatic resections and the surgical treatment of portal hypertension with all kinds of shunt techniques, including "Rex shunts". The Unit is also a leader within Spain for the treatment of congenital portocaval shunts.
The Cabinet of Digestive Physiology is a leading name in the study of gastroesophageal reflux (pH-metrics and bioimpedimetry) and anorectal manometry.
We cannot think of children as miniature adults, their bodies are growing and developing until they point they reach skeletal maturity. Medical professionals treating diseases of and injuries to the bones, joints and muscles of children must be experts in the specific nature of said diseases and injuries. Paediatric Orthopaedic Surgery is the subspecialty that is deals with these problems in children.
Between childhood and adolescence, there are many varied osteoarticular processes that children may experience. If we look at age, it is obvious that the issues faced by babies vary greatly from those faced by adolescents. So, while congenital abnormalities and postural deformities are most common in babies, young children present more disorders in gait and deformities of the limbs. Later on, when the children are older, several pathologies of the hip and spine can appear. Once a child reaches adolescence, fractures are the most common issue. The origin of the different problems is also very diverse, and can include infectious or tumoural congenital processes.
Many paediatric diseases manifest with skeletal deformities or disorders of function, which is why paediatric orthopaedic specialists must work in coordination with the other Paediatrics specialists: neonatologists, neurologists, nephrologists, endocrinologists, rheumatologists, pneumologists, oncologists and gastroenterologists. In turn, they need the collaboration of other specialists such as radiologists, anaesthetists, rehabilitators and pathologists.
The Paediatric Orthopaedic Surgery Unit of our hospital is accredited as a centre of reference for the various pathologies covered by our specialty, as well as neurodegenerative diseases (childhood cerebral palsy, spina bifida, neuromuscular diseases, peripheral neuropathies) bone dysplasia (achondroplasia, imperfect osteogenesis) and major bone deformities (stretching and bone corrections). We also collaborate with other departments and units in other pathologies that are also considered reference centres in our hospital: such as the CSUR in childhood sarcomas.
The members of the Unit are fully qualified and trained to perform non-surgical and orthopaedic treatments that cover the subspecialty of Paediatric Orthopaedic Surgery.
The Unit is located at the Vall d’Hebron Maternity and Children's Hospital and falls under the Orthopaedic Surgery and Traumatology Department.
The Paediatric Orthopaedic Unit has five lines of research underway:
The Paediatric Heart Surgery Department is one of the oldest in Spain, with more than 5,000 operations performed with extracorporeal circulation and more than 40 years of activity behind it. We are a national reference centre for the treatment of congenital heart disease, and can offer surgery for all kinds of diseases.
The pathologies we treat at our Department all present with their own specific traits. This means the simplest forms of heart disease can happen while presenting hardly any symptoms. In contrast, the most complex forms appear during the neonatal period in the form of heart failure and cyanosis (lack of oxygenation).
According to official data, about 500 children with congenital heart disease are born in Spain a year, of which 60% of cases will require surgical treatment within the first year of life. These are the most common congenital malformations that occur in 8 out of every 1,000 births.
For a basic diagnosis of congenital heart disease, echocardiographies, electrocardiograms and chest X-rays are performed. There are cases where diagnosis with other imaging tests must be used, such as magnetic resonance imaging and computed axial tomography (CAT scan), stress tests or other more invasive methods, such as heart catheterisation, where a catheter is inserted into the cardiac cavities, and electrophysiological studies, where a puncture is made into the femoral vein, and one or more catheters are inserted.
These pathologies usually require an operation. This is why we have a high-tech operating theatre that allows intra-surgical monitoring, with anaesthetists and specialist nursing staff. As for primary prevention, though there is not much information on what can be achieved, a series of measures can be taken, such as control of maternal diabetes and rubella vaccinations, and, during pregnancy, avoiding exposure to teratogens, such as alcohol or thalidomide.
Outstanding professionals in these pathologies include Dr Raúl Abella, Dr Joaquín Fernández Doblas and Dr Joaquín Pérez Andreu. The work carried out by paediatric cardiac surgeons is supported by Paediatric Cardiology, Anaesthesia, Perfusion and Surgical Nursing. Support from intensive care units, both neonatal and paediatric, where all of our patients, are treated, is essential.
We have several specific areas of excellence that place us at the forefront of paediatric cardiac surgery. We run the following programmes:
Some congenital heart diseases require surgical correction during the first month of life. We have specific neonatal programmes, such as the univentricular heart programme, left cavity hypoplasia and pulmonary atresia.
We have extensive experience performing Ross surgery (valvular autograft), even in the neonatal period.
We support all patients suffering from severe cardiac issues. We are part of the ECMO programme (Extra Corporeal Membrane Oxygenation) that offers comprehensive life support to the patient. We are one of the most experienced hospitals in Spain in ventricular assistance programmes.
We are one of the hospitals in Spain with the highest number of transplant patients. Since 2006, we have carried out more than 50 heart and lung transplants.
Hypoplasia of left cavity is one of the most complex congenital heart diseases (Norwood operation). We have a hybrid room equipped with the right instruments to carry out combined procedures.
Pulmonary atresia with ventricular septal defect is one of the most complex heart diseases. In the most serious cases, there is severe hypoplasia of these pulmonary arteries, meaning the blood reaches the lungs through arteries from the aorta. We treat this pathology from the neonatal period to obtain the best results in the long term.
The Gynaecological Oncology and Lower Genital Tract Pathology Unit is a part of the Gynaecology Department. It treats all genital cancer diseases in the Hospital's catchment area, as well as more complex cases with requirements that exceed the capacity of other health centres in Catalonia.
Our mission is to provide effective, efficient and quality healthcare in the treatment of diseases. Our guiding principle is comprehensive care, where treatment, teaching and research combine to offer the public the highest quality competitive service.
We treat complex pathologies that require multidisciplinary care in which professionals from different disciplines work together. The future of gynaecological oncology pathology is promising, and we have excellent results: between 80% and 90% of cases are resolved with non-invasive surgery, be it laparoscopic, robotic or vaginal. This helps improve the quality of life of our patients.
We work to continue making progress, not only in the care we provide, but also in basic research, which will ultimately improve the care our patients receive. Our mission is for the Gynaecological Oncology and Lower Genital Tract Pathology Unit to lead the way as a cutting-edge centre of excellence with the latest technology, both within the Hospital and in the Catalan public health system as a whole.
Our Unit is one of the most active in the country, and is a reference in gastroenterology, that is, the digestive system, both as part of the Catalan Health Service and the Catalan Health Institute (ICS) and the rest of Spain, where we lead several educational and research projects.
Our centre’s Paediatric Gastroenterology Unit was founded in the early 70s by Dr Ramon Tormo, who was joined soon after by Dr Dámaso Infante. Together, they were pioneers in Paediatric Gastroenterology in Spain, and for more than three decades they consolidated this unit as one of the most recognised and prestigious nationwide.
Now it is known as the Gastroenterology, Hepatology, Nutritional Support and Paediatric Hepatic Transplant Unit, and is a reference centre for treating children with gastroenterological (digestive), hepatic (specifically liver and biliary tract) and/or nutritional illnesses.
Our Unit provides care for patients in the catchment area of Vall d'Hebron University Hospital, as well as taking over highly complex cases or patients that exceed the capacity of other hospitals, in both Catalonia and the rest of Spain.
The gastroenterology area is a multidisciplinary unit, dedicated to providing specialist, comprehensive, personalised care for patients affected by gastroenterological diseases, whatever the seriousness or number of cases among the general population. With more than 35 years of experience and a proven vocation for constant innovation in diagnosis and treatment, we continue to be pioneers in paediatric gastroenterology in Spain.
The multidisciplinary Hepatology Unit focuses on the needs of patients receiving liver transplants as well as patients affected by severe liver disease. With more than 25 years of experience, this unit is a pioneer in hepatic transplants in Spain, carrying out the first liver transplant in Spain in 1985.
It is now one of the most active units nationwide, and is a reference centre for liver transplants in children at the national level (CSUR). The unit treats children with severe liver disease and provides specialist, comprehensive, personalised care.
The multidisciplinary Nutritional Support Unit, which is a part of the Transversal Nutritional Support Unit, works together with the Paediatric Gastroenterology Unit, treating all patients with special nutritional requirements (those affected by oncological diseases, nephropathy, complex heart disease, solid organ transplants (spinal cord, liver, kidneys, etc.), congenital metabolic defects, etc.).
In addition to providing comprehensive, specialist support, the unit has run a Home Artificial Nutrition programme since 1998, both enteral (by tube) and parenteral (intravenous), which applies nutritional support procedures to stable patients in their own homes, enabling them to leave the hospital and improve their quality of life.
This unit is also responsible for patients with Short Intestine Syndrome, which is part of the intestinal rehabilitation programme, whose main objectives are to maintain the nutritional status of patients and promote the intestinal adaptation of the remaining intestine. This programme has extensive experience in prolonged Parenteral Nutrition (management of central lines, infusion systems, family training, etc.) and paediatric digestive surgery (autologous reconstruction techniques, that is, using the patient’s own tissue) of the intestines, including STEP and Bianchi intestine-stretching techniques) of the kind that child patients require.
Our team consists of: a coordinator, Oscar Segarra; attending physicians, Marina Álvarez, Jesús Quintero, Javier Juampérez, Susana E. Redecillas and Raquel Núñez; Primary care colleagues specialising in this specialty at COAP Sant Andreu - Casernes, Rebeca Corral and Toni Muntaner; Nurses, Carmen Arenas and Lis Vidal. Also, as part of the Master’s in Paediatric Gastroenterology 2017: Maria Mercadal and Cinthia Virginia Flores.
Thanks to our multidisciplinary team, with the collaboration of the staff and infrastructure of the General Hospital for adults, we can provide highly specialised, comprehensive medical and surgical attention to all patients who require it.
The Unit regularly participates in studies and clinical trials. All these are approved beforehand by the centre’s Clinical Research Ethics Committee. The main lines of research are based on the application of new techniques and procedures that allow us to make improvements in the short, medium and long term in the diagnosis and/or treatment of certain pathologies:
As a specialised reference unit, the Paediatric Gastroenterology Unit is responsible for significant teaching activity:
The main objective of the Pharmacy Department is the safe and efficient use of medication with the utmost excellence. Our Department supports care activity and is recognised as a collaborating centre of the Institute for Safe Medication Practices (ISMP), thanks to our role in preventing medication errors.
Our Department offers a consolidated portfolio of services, and we have a pharmaceutical team that monitors all registered prescriptions and pharmaceutical treatments.
We are responsible for distributing, dispensing and preparing medications with automatised systems and robotics, with one of the most significant technological systems in Europe. We use a system of drug-use indicators based on case histories to assess use of medication. This helps us detect opportunities for improvement, both in terms of security and reducing variability in clinical practice, meaning avoiding differences in the way our staff prescribe treatments.
The Department enjoys ISO 9001-2008 certification, which specifically covers prevention of medication errors. We have established a quality policy aimed at satisfying the needs and expectations of patients, and providing the services that contribute to improving quality of care through personalised attention for effective, efficient and safe drug treatment, while improving our systems.
Our main objective is to ensure our Department continues to contribute value to patients, bearing in mind the conditions at any given time in the Hospital, the Catalan Health Institute and the Catalan Health System in general. For this reason, between 2009 and 2015 we followed a strategic plan that uses the Balanced Scorecard methodology. This strategic plan takes into account new scenarios, social changes and emerging trends, which all necessitated a thorough review of our methodology, in a spirit of critical creativity and continuous improvement.
Rapid evolution in concepts and technology has resulted in the Pharmacy Department receiving several awards and honourable mentions for our clinical innovation and excellence.
The Thoracic and Airway Surgery Unit is part of the Paediatric Surgery Department, and emphasises the treatment of congenital pulmonary malformations of the thoracic wall through the application of minimally invasive orthopaedic surgery techniques in selected cases.
Our unit coordinates a multidisciplinary team for treating paediatric airways. We have a great deal of experience in the treatment of infections due to pus accumulated in the lungs (complicated parapneumonic empyema). We coordinated the first multicentre trial published in the world, meaning a clinical trial with several research centres or hospitals and with randomised patients, to compare video-assisted thoracoscopy with treatment with fibrinolytic drugs.
The treatments we offer are the following:
At the Plastic Surgery and Burns Department, we treat diseases of the whole human anatomy and specialise in transplant techniques for the face and extremities, tissue regeneration and reparative microsurgery and more. Constantly striving for innovation, we are a pioneering Department internationally in total facial transplants and stem cell treatment of burn scars.
Constantly striving for innovation, the Plastic Surgery and Burns Department was a pioneering service internationally in total facial transplants and stem cell treatment of burn scars.
At the Plastic Surgery and Burns Department, we handle congenital or acquired diseases that affect soft tissue and bone, traumatisms and large burns, as well as specialising in face, limbs, grafts, treatment of tumours and significant deformities and regeneration of tissues and reparative microsurgery, and more.
We treat diseases that require the use of plastics and tissues in the form of flaps and biomaterials. For these treatments, we often use advanced wound healing, microsurgery and endoscopy techniques. We treat the whole body, but focus on the face, the skull and the neck, as well as the torso, in particular the mammary glands, and the extremities, especially the hands and the legs.
Our main objective is reparatory surgery. We specialise not only in techniques for transplants of the face and extremities, but also in biomaterials and tissue regenerators, adult stem cells and reparative microsurgery.
With over 50 years of history, Plastic Surgery and Burns Department is a leading centre in severe burns and a Spanish Reference Centre (CSUR) for complex reconstruction of the auricle, microtia, face and hand treatment and stem cells and major catastrophes. Tragedies such as the Hipercor terrorist attack and the fire at the Els Alfacs campsite are examples of this.
Plastic surgery is highly focused on hospital services and is a multidisciplinary specialty, characterised by constant innovation, the relationship with other specialties and the constant search for excellence. We were pioneers internationally in total facial transplants and in treatment with stem cells for burn scars.
Our Department is home to many functional units, and we participate in various multidisciplinary teams from other specialties; the Burns Unit, the Microtia and Facial Malformation Unit, the Breast Pathology Unit and the Face and Extremities Transplant Unit are all worthy of mention.
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