Resection of Nephroblastoma (Wilms tumor) in Childrens Hospital Nuremberg

About the department

The Department of Pediatric Surgery and Urology at the Children's Hospital Nuremberg offers the full range of diagnostics and treatment for young patients in the areas of its competence. The department provides highly qualified medical care for newborns, young children, and adolescents up to the age of 18. Special attention is paid to the surgical repair of congenital malformations, surgery for gastrointestinal diseases, malignant tumors, pathologies of the reproductive system in boys, and diseases of the urinary system in boys and girls. The department has accumulated impressive experience in the treatment of hydrocephalus and spina bifida. The young patients receive both inpatient and outpatient medical care in the department. The health facility has 42 beds for patient accommodation. The department's team of doctors cares about the maximum comfort of young patients, and therefore, the accommodation of one of the parents with a child is also possible. It is important for specialists to provide the child with effective treatment without pain, so sparing therapeutic techniques are used here. Many surgical interventions are performed using minimally invasive techniques without any extensive skin or soft tissue incisions. The department has an excellent technical base and comfortable infrastructure adapted to the needs of children. Special attention is devoted to creating a pleasant and friendly atmosphere, along with providing sensitive care for the child. The department is headed by Prof. Dr. med. Dr. h.c. Maximilian Stehr.

The team of the department's surgeons specializes in the treatment of gastrointestinal diseases in children. The doctors focus on young patients with esophageal stricture, Hirschsprung's disease, anorectal atresia, and bowel obstruction. An esophageal stricture in a child involves the narrowing of the lumen of the organ that hinders the movement of food to the stomach. The most effective methods of eliminating stricture are balloon dilatation with endoscopic techniques and classical surgery. The last option is considered a last-line treatment and involves the resection of the narrowed esophageal segment followed by esophagoplasty (replacement of the removed part of the esophagus with stomach or intestinal tissue).

The department's pediatric surgeons often treat young patients with Hirschsprung's disease. The disease is a congenital colon anomaly characterized by the absence of nerve cells (ganglia) in certain segments. The pathological condition leads to impaired peristalsis and prevents the normal movement of the food bolus through the digestive tract. The only effective treatment option for Hirschsprung's disease is surgery. The extent of surgery depends on the age of the child, the extent of the affected intestine, and the complexity of the resulting disorders. The department's specialists perform single-stage and two-stage interventions for Hirschsprung's disease. In the first case, the surgeon removes the affected segment of the colon and immediately forms an anastomosis to restore the continuity of the digestive tract. A two-stage operation involves excision of the affected colon with the formation of a colostomy for fecal diversion. Surgeons then perform reconstructive plastic surgery, during which the colostomy is sutured with a bowel anastomosis. Surgery for Hirschsprung's disease may also be performed using minimally invasive techniques, if clinically indicated.

An integral part of the department's clinical practice is the conservative and surgical treatment of bone fractures and other injuries in children. Simple bone fractures are treated with casts or splinting, and in complex cases, the department's specialists perform osteosynthesis with bone fragment repositioning. In some situations, external fixation systems can be used for complex fractures to immobilize the extremity. The department’s doctors take care to eliminate pain as much as possible, so adequate pain relief is used during treatment.

The department has gained long experience in the surgical repair of hydrocephalus and spina bifida in children. Hydrocephalus (water on the brain) is a condition characterized by the accumulation of cerebrospinal fluid in the cerebral ventricles and, sometimes, in the subarachnoid space. The pathological process affects the physical and psycho-emotional states of the child. The most common treatment method for hydrocephalus is shunting. Surgeons implant a special system of tubes and valves in the brain to redirect excess cerebrospinal fluid to other body cavities (most often into the abdominal cavity).

The department's range of medical services also includes the treatment of urologic diseases in children. Doctors regularly treat varicocele, hypospadias, and cryptorchidism in boys, ureteropelvic junction obstruction, enuresis, and other bladder emptying disorders. Depending on the particular clinical case, conservative or surgical treatment may be prescribed for the child. For example, surgical methods (most often minimally invasive) are used to repair hypospadias and varicocele, while enuresis responds well to conservative therapy.

The department's key clinical areas include:

• Pediatric surgery
  • Neonatal surgery
    • Surgical repair of congenital malformations in newborns
  • Surgery for gastrointestinal diseases
    • Surgery for esophageal stricture
    • Surgery for Hirschsprung's disease
    • Surgery for anorectal atresia
    • Surgery for bowel obstruction
  • Surgery for malignant tumors
  • Conservative and surgical treatment of bone fractures and other injuries
  • Removal of hemangiomas and lymphangiomas using laser and cryotherapy techniques
  • Surgical repair of the hydrocephalus and spina bifida
  • Surgical repair of pectus excavatum
• Pediatric urology
  • Surgical repair of congenital malformations of the reproductive system in boys
    • Varicocele
    • Hypospadias
    • Cryptorchidism
  • Surgical repair of ureteropelvic junction obstruction
  • Conservative treatment of enuresis and other bladder emptying disorders
• Other medical services