Cincinnati Children’s is a free-standing children’s hospital with over 600 beds and serves as a Level 1 ACS verified trauma center. In the fall of 2021, we will be opening the new critical care building that will expand capacity for the NICU, CICU, PICU, and Emergency Department. Our level IV NICU currently has over 70 beds and serves as a regional referral center for neonates requiring surgery or subspecialty pediatric evaluation.
Top Hospital In The Nation
Cincinnati Children’s is consistently ranked in the top 3 children’s hospitals in the country by US News and World Report. Our fellows have the unique experience of training at a hospital that serves both the local community as well as a broader national and international population of patients. Our division performs more than 4000 operative procedures per year.
The surgical faculty at Cincinnati Children’s practice general pediatric surgery as well as maintaining specialty expertise in specific aspects of pediatric surgical disease. Click here to virtually “meet” our faculty! [link to faculty page]. We consider the access to specialty programs to be of significant benefit to our trainees. We also recognize that all trainees come with different backgrounds and different career interests; we allow our fellows to tailor their own experience, while ensuring that all ACGME case requirements are filled. Below is a description of how the specialty programs impact the training of our fellows.
Pediatric Colorectal Program
Our colorectal team cares for thousands of patients with pediatric colorectal disease encompassing anorectal malformations, Hirschsprung disease, Inflammatory bowel disease, and difficult-to-manage constipation. Our robust bowel management program sees several hundred new patients per year. Our fellows participate in the inpatient and outpatient care of these patients and many of our fellows have gone on to become the colorectal expert in their subsequent practice. From an operative standpoint, our fellows perform a large number of PSARPs (including persistent cloaca), pull through procedures for Hirschsprung disease, Malone procedures for management of fecal incontinence or constipation, bowel resections and stoma creation for a variety of conditions including IBD, J pouch creation for ulcerative colitis and FAP, and placement of sacral nerve stimulators for management of fecal incontinence or constipation
Fetal Care Center
As one of the few free-standing children’s hospital with a maternal delivery unit, the fetal surgery program is one of the most active programs in the country. Our fellows participate in the prenatal counseling of mothers expecting babies with conditions that are likely to require surgery in the neonatal period and depending on the type of procedure, fetal interventions. The center performs over 100 fetal procedures per year and sees 500-600 new patient consults with expecting families. Our center offers fetal tracheal occlusion (FETO) for the management of congenital diaphragmatic hernia (CDH), which draws a large number of babies with CDH to Cincinnati.
Hepatobiliary and Solid Organ Transplantation Program
Our program is somewhat unique in that we have four faculty members who have completed both pediatric surgery and transplant fellowships. We offer kidney, liver, multi-visceral, and small bowel transplant utilizing both deceased and living-related donors. Fellow participation in the transplant program is voluntary and based on the interest of the trainee. Many fellows choose to participate in the kidney transplants to hone their vascular anastomosis skills and also frequently participate in the hepatectomy for patients undergoing liver transplant due to malignancy. In addition to offering a full array of transplant services, this faculty has a particular expertise in hepatobiliary procedures. Common procedures performed include Kasai portoenterostomy, choledochal cyst excision (including robotic), biliary diversion, porto-systemic shunt creation, and hepatectomy for malignant and benign conditions. Recently, a multi-disciplinary pancreas program was established and has become one of the busiest pediatric programs in the country performing total pancreatectomy with islet autotransplantation.
The oncology and bone marrow transplant services in Cincinnati are recognized nationally and internationally, and thereby draw a larger than expected volume of solid tumor patients to our center. Multidisciplinary tumor boards occur weekly; fellows are encouraged to participate in this activity. We perform a variety of oncologic surgeries including hepatectomy, nephrectomy (including nephron sparing surgery), excision of neuroblastoma, thoracoscopic and open metastatectomy for many tumors including sarcoma, and debulking laparotomy with HIPEC.
The Chest Wall team sees a large volume of pectus carinatum and pectus excavatum patients in its dedicated outpatient clinic. A large volume of pectus excavatum patients undergo surgery utilizing both minimally invasive and open techniques. Our patients tend towards the more severe end of the spectrum, giving fellows the opportunity to learn strategies for managing even the most complex chest wall patients.
The vascular anomalies clinic in Cincinnati has a long-standing history of comprehensive care and innovative therapies. Our center was one of the first in the country to use sirolimus in the treatment of complex anomalies. A weekly multi-disciplinary conference and clinic allows the fellows to learn how to both evaluate, diagnose, and treat patients presenting with a wide variety of vascular anomalies including: hemangioma, venous malformation, arteriovenous malformation, lymphatic malformations, and rare vascular tumors like Kaposiform hemangioendothelioma. While a majority of these patients are treated non-operatively, operative management is still an important component of the care algorithm with interventions ranging from simple and complex hemangiomas to laser treatment of more superficial lesions to resection of massive mixed venolymphatic malformations.
The Aerodigestive Center at Cincinnati Children’s brings together members of the ENT, GI, pulmonary, and pediatric surgery teams to coordinate the care of children diagnosed with complex airway and/or digestive issues and was one of the first of its kind in the world. A subset of the patients seen in this center are patients with esophageal atresia, frequently patients with complicated surgical histories. Through this highly sought-after program come a variety of patients needing complicated esophageal repairs to deal with strictures, recurrent tracheoesophageal fistula, and long-gap esophageal atresia. Our center is also currently offering magnet therapy for patients with long gap atresia who meet inclusion criteria.
Cincinnati Children’s has an active bariatric surgery program with 50-60 surgeries performed annually and 90-100 new patient evaluations. Fellow participation in the bariatric surgeries is based solely on the interest of the trainee. A full range of procedures is offered, with the most commonly performed currently being a laparoscopic sleeve gastrectomy.
Our faculty are active globally, working on improving pediatric surgery capacity in low- and middle-income countries. This work focuses on health system strengthening, as well as capacity building through training of local providers. Two of our current, active collaborations are in East Africa – in Uganda and in Tanzania. Each fellow is given an opportunity (typically in the second year) to participate in one of these collaborations along with the faculty member(s) as a member of the team traveling overseas. Historically the fellow has participated in the experience in Tanzania, which is focused on colorectal surgeries.
Because of the complexity of the population of patients that we serve, we offer subspecialty fellowship training opportunities in colorectal, ECMO, fetal, trauma and vascular malformations, as well as an international fellowship for trainees from other countries. Fellows in these positions contribute to the care paradigm, supporting the day to day activities of the accredited fellows.