We are the combination of four hospitals: the General Hospital, the Children’s Hospital, the Women’s Hospital and the Traumatology, Rehabilitation and Burns Hospital. We are part of the Vall d’Hebron Barcelona Hospital Campus: a world-leading health park where healthcare plays a crucial role.
Patients are the centre and the core of our system. We are professionals committed to quality care and our organizational structure breaks down the traditional boundaries between departments and professional groups, with an exclusive model of knowledge areas.
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The commitment of Vall d'Hebron University Hospital to innovation allows us to be at the forefront of medicine, providing first class care adapted to the changing needs of each patient.
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.
Neonatal surgery requires detailed knowledge of complex pathologies in patients who also have special conditions that are different from other paediatric patients. The Neonatal and Foetal Surgery Unit covers practically every surgical neonatal pathology, and it is a reference centre both nationally and on a European level. It is part of ERNICA, the European Reference Network (ERN) for Rare Inherited and Congenital Digestive Disorders. In recent years, the Unit has been firmly committed to introducing minimally invasive surgical techniques, achieving excellent results.
We work in conjunction with the Neonatology Department. The Neonatal Intensive Care Unit (NICU) at Vall d’Hebron Hospital is one of the largest in the country and has one of the best survival rates. We have the possibility of performing surgical interventions within the NICU if transporting the newborn patient to the surgical wing would be too risky due to the instability of their condition.
Similarly, we work closely with the Foetal Medicine Unit, whose services include all the currently valid prenatal and intrapartum (EXIT technique) foetal surgery techniques.
The Unit participates in the following sessions and committees: Neonatal Medical-Surgical Session (Tuesdays at 1 pm), Paediatric Airway Committee, Birth Defects Committee.
Within our areas of interest, we highlight oesophageal atresia, a pathology for which our overall survival rate exceeds 95% in patients who do not present complex associated malformations. Patients with long-gap oesophageal atresia continue to be a challenge, as the distance between the ends is so great that a primary repair cannot be done. In these complex patients, besides applying the different classic techniques, we use the Foker technique, which consists of sustained traction on the ends to be connected in order to stimulate their growth, so that oesophageal anastomosis can finally be achieved. In those patients for whom the native oesophagus cannot be saved, we carry out oesophageal substitution via gastric pull-up, with excellent short-term and long-term results.
We have established a comprehensive treatment plan for patients affected by a congenital diaphragmatic hernia (CDH), which includes foetal treatment (using the FETO technique: Foetal Endoscopic Tracheal Occlusion) in cases where CDH has been diagnosed in the foetus and the prognosis is not good. In addition, the hospital offers every type of invasive and non-invasive respiratory support and therapy available today: synchronised mechanical ventilation, HFOV, CPAP, treatment with inhaled nitrous oxide, and ECMO (extracorporeal membrane oxygenation), providing cardiovascular and respiratory support when conventional treatment proves ineffective. In patients with large diaphragmatic defects, we use several types of patches, both synthetic and biological ones, and techniques that use autologous muscle flaps, generally from the abdominal wall.
The main abdominal wall defects we find are gastroschisis and giant omphalocele. We are especially proud of how we handle gastroschisis, which can be associated with severe medical-surgical problems due to the inflammation and thickening of the exposed intestinal loops caused by the irritation produced by the amniotic fluid at the end of gestation. Since 2002, we have been carrying out a strategy to avoid this, consisting of performing a scheduled Caesarian section at 34-35 weeks of gestation. This elective preterm C-section technique allows for the abdominal defect to be closed directly, as it reduces exposure to amniotic fluid. With more than 50 patients treated this way, we have not observed complications linked to prematurity. Instead, we have detected a decrease in the associated complications, an earlier introduction to food, and a reduced hospital stay, as well as better aesthetic outcomes, since the scar is hidden by the belly button. We have vast experience in treating giant omphalocele. For this, we use surgical techniques that employ vascularised flaps, biologic or synthetic mesh, and vacuum-assisted closure (V.A.C.®).
Our overall survival rates for acquired surgical pathologies such as necrotising enterocolitis and intestinal perforation (both in premature and LGA premature - with a birth weight of less than 750g - babies) is comparable to other European reference centres. This is thanks to the application of our philosophy of minimally aggressive surgery and conservative treatment; applying these principles is the underlying reason for our high rates of survival and preservation of native intestine.
Intrauterine or peripartum surgery
Pathologies of the disgestive tract
Pathologies of the abdominal wall
Pathologies of the lungs and respiratory tract
Others
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