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.

The Cardiology Department Teaching Unit at Vall d’Hebron Hospital is divided into nine operational units. These include Outpatients, conventional wards, the Day Hospital, the Coronary Care Unit, Intensive Coronary Care, Semi-critical Care, Echocardiography and Cardiac Imaging, Haemodynamics and Angiocardiography, Arrhythmia, Nuclear Cardiology and the Experimental Laboratory. It should be said that the Cardiovascular Epidemiology Unit, part of the Cardiology Department, is unique within Spain.

We work in multidiscipline areas to treat specific medical problems such as Marfan syndrome and Congenital Heart Disease, and are national leaders in both fields. Our activity is always patient-centred and aims to maximise outpatient care and general cardiology. To this end we regularly run clinical care and scientific sessions that involve all professionals in the Department.

During training, residents progressively increase their level of skill, from taking medical histories at the start of their training, for example, to the use of automatic defibrillators in the final phase of their residency. 

During the first year residents undertake shifts in Internal Medicine, with one shift a month in Cardiology. In the second and third year they do shifts in clinical cardiology within the Accident and Emergency Department. The fourth and fifth year include shifts in the Coronary Care Unit and Haemodynamics.     

In terms of training, there are sessions, seminars and courses, and residents’ participation in national and international congresses, conferences, seminars and courses is encouraged.

At the end of the cardiology residency, it is possible to continue training in research as part of the Riu Ortega programme for the Carlos III Health Institute. We also take part in undergraduate and postgraduate research staff training programmes run by the Generalitat of Catalonia’s Department for Education and Universities and the Ministry of Education.

Research activities  of note include collaboration with the International Doctorate School on myocardial consequences, in cooperation with the University of Giessen (PROMISE), funded by the German organisation DFG and BIOCAT.

Why should you specialise at Vall d’Hebron?

• Because the Multidiscipline Unit of Adult and Adolescent Congenital Heart Disease is a leader within Spain.
• Because we are a national point of reference through the development of the European Cardiology Society’s clinical practice guides for disorders such as valvulopathy, endocarditis, aortic pathology, coronary syndrome, syncope, congenital heart disease, acute coronary syndrome and pericardium disease.
• Because we are national and international pioneers who have been developing our own healthcare protocol for each cardiac pathology since 1981.
• Because we offer residents shifts in Cardiology within the Accident and Emergency Department, supported by a consultant and two residents in person, and a haemodynamics specialist who can be reached if necessary.
• Because in Cardiac Care we have a daily meeting with the previous shift attended by the team on duty, the Head of Department and the Heads of Unit.
• Because we have a daily Coronary Care Unit meeting at the end of every day, attended by staff doctors, residents, and the consultant and resident who have been on duty.
• Because we organize two weekly nuclear cardiology sessions, attended by the cardiologist in charge of the section, the cardiology resident and doctors from Nuclear Medicine.
• Because we carry out three cardiac imaging sessions a week, attended by the doctors training in the echocardiography and ergometry unit, during which cardiac MRI and CT scans are discussed, along with echocardiographic and magnetic resonance assessments of particular interest.
• Because we hold a weekly session on electro physiology and arrhythmia with paediatric cardiology and adult congenital heart disease.
• Because we deal with infectious endocarditis (in collaboration with Bacteriology, Infectious Diseases and Cardiac Surgery) in a dedicated weekly session.
• Because we hold weekly seminars in the Experimental Cardiology Laboratory, and fortnightly seminars from the Vall d’Hebron Research Institute.
• Because the top cardiologists and cardiovascular researchers in Spain and Europe take part in our clinical sessions, which are recognised by the SNS (National Health Service) Continuous Professional Development Commission, and the Catalan Council for Continuing Medical Education.
• Because every year we offer courses in echocardiography, pacemakers and arrhythmia, adult congenital heart disease and nuclear cardiology, and Advanced cardiopulmonary resuscitation courses organised for Cardiology residents, in addition to other courses.
• Because we encourage residents to take part in the National Cardiology Congress and the European Cardiology Congress during the final years of their residency.
• Because we enable residents to undertake part of their residency training in other centres, particularly in New York, Washington, London and Cologne.

The Allergology Unit has been training residents since 1982, and is where most heads of allergology divisions in Catalonia did their training.

We attend to outpatients regarding allergic respiratory disease, paying special attention to asthma, complex food allergies, hymenoptera allergies, chronic urticaria, atopic dermatitis, and drug allergies.

The Day Hospital carries out controlled drug exposure tests and chemotherapy and other drug desensitization therapies. The paediatric unit carries out food desensitization therapies. We also deal with hospital consultations on a daily basis.

The unit carries out clinical research  in the fields of  anaphylaxis, hereditary angioedema, food allergies  and  chronic urticaria. In terms of  experimental research , we offer the opportunity to carry out specific immunoglobulin E and G tests by biochip, and  basophil activation tests. Five doctoral theses have been supervised by the Unit and all its staff physicians are qualified Doctors of Medicine.

Why specialise at Vall d’Hebron?

• Because we are a tertiary hospital with outstanding departments. The number of patients who pass through the centre offers great potential for learning and gaining experience.
• Because we cover most specialisations and you will have the opportunity to see complex pathology and to use cutting-edge diagnostic techniques and treatments.
• Because our training programme can adapt to the initiative and vocation of each resident, with more emphasis on patient-contact or research according to their needs.
• Because you will have the opportunity to see complex pathology and use cutting-edge diagnostic techniques and treatments, such as monoclonal antibodies, the application of drug desensitization protocols and the management of hereditary angioedema.
• Because you will have the opportunity to present papers at national and European allergy conferences. At the most recent events we received awards for the best paper in several areas.
• Because we give fourth year residents contacts to assist with research and stays abroad. In recent years our residents have spent time in clinical allergy units in Rome and Montpellier, and in research centres such as the Karolinska Institute in Stockholm, Sweden. All fourth year residents are offered funding for the European Examination in Allergology and Clinical Immunology, which 85% of our residents have successfully passed to date.
• Because your knowledge will be continuously updated through a programme of specialised, literature and clinical sessions, which take place four days a week.
• Because in 2010 the Allergology Teaching Unit was assessed by the Allergology Department of the European Union of Medical Specialists, who accredited it as a Specialised Allergy and Immunology Training Unit.

Prospective radiologists need a solid medical foundation to work closely with specialists from other medical disciplines. For this reason, training in diagnostic imaging, clinical radiology and bioethics is complemented with knowledge on pathological and functional aspects of diseases. 

Why specialise at Vall d’Hebron?

• Because we are a tertiary hospital with outstanding departments. The number of patients who pass through the centre offers great potential for learning and gaining of experience.
• Because we cover most specialisations and you will have the opportunity to see complex conditions and to use cutting-edge diagnostic techniques and treatments.
• Because our training programme can adapt to the initiative and vocation of each resident, with more emphasis on patient-contact or research according to their needs.

This includes basic clinical knowledge of diagnostic techniques, dietary and therapeutic measures and all aspects of preventative medicine related to these fields. Other specialist departments are also involved in the Endocrinology and Nutrition Teaching Unit, such as Internal Medicine, Cardiology, Nephrology, Neurology, Paediatrics, Nuclear Medicine, and the Nutritional Support Unit and the Accident and Emergency Department.

Why specialise at Vall d’Hebron?

• Because we are a tertiary hospital with outstanding departments. The number of patients who pass through the centre offers great potential for learning and gaining of experience.
• Because we cover most specialisations and you will have the opportunity to see complex conditions and to use cutting-edge diagnostic techniques and treatments.
• Because our training programme can adapt to the initiative and vocation of each resident, with more emphasis on patient-contact or research according to their needs.

Why specialise at Vall d’Hebron?

• Because you will be trained in the care, diagnosis and treatment of skin problems, and will be able to advise patients on how to prevent dermatological conditions.
• Because you will be able to spend a significant part of your residency on the severe and complex dermatoses seen in a technologically advanced hospital such as Vall d’Hebron. This means you will be able to work in subspecialisations such as cutaneous oncology and hospital admissions due to dermatological disorders as well as in the Day Hospital.
• Because at the end of the residency you will have gained experience in therapeutic management of the most common dermatoses, which are likely to be the most common reason for patient visits throughout your career.
• Because you will have mastered complementary diagnostic examination procedures and therapeutic techniques specific to the specialisation, such as phototherapy, cryotherapy, and dermatoscopy.
• Because you will be able to undertake rotations in the unit on cutaneous tumours, minor dermatological outpatient surgery, paediatric dermatology, and outpatient clinics on oncohaematological cutaneous diseases and pigmented lesions.