The Division of Pediatric Neurosurgery at British Columbia’s Children’s Hospital (BCCH) is the major referral center for pediatric neurosurgical conditions in the province of British Columbia.
The Division has established itself as one of the foremost pediatric neurosurgical units in Canada and is acclaimed internationally as a leader in pediatric neurosurgery. The Division comprises four full-time pediatric neurosurgeons: namely, Dr. Douglas Cochrane who is head of the division, Dr. Ash Singhal and Dr. Paul Steinbok. All three neurosurgeons are fully trained in pediatric neurosurgery and have limited their practices to the care of children with pediatric neurosurgical conditions.
The Division of Pediatric Neurosurgery is located at B.C. Children’s Hospital, a part of Children’s and Women’s Health Centre. This is a tertiary care children’s hospital with the full range of support services and the most modern equipment available for the management of neurosurgical disorders in children. The pediatric neurosurgeons are supported by a team of pediatric neurologists, intensivists, pediatric neuro-radiologists, pediatric neuro-pathologists, pediatric electrophysiologists and nurses, physiotherapists occupational therapists and social workers specifically trained in the management of neurological diseases in children. There are a number of well-established, multidisciplinary programs including a spina bifida program, spasticity and motor disorders program, an epilepsy surgery program, a neuro-oncology program, and cranio-facial program.
The Division performs approximately 300 neurosurgical operations yearly, and addresses the full range of neurosurgical conditions in children. These include surgeries for brain and spinal tumors, Chiari malformations, Moya Moya disease, syringomyelia, craniosynostosis, hydrocephalus, spina bifida, epilepsy, head injuries and cerebral palsy, among others. The neurosurgeons are experienced with neuroendoscopic and image guided neurosurgery.
The neurosurgeons at B.C. Children’s Hospital have developed a team approach to the management of patients. Difficult clinical cases are routinely discussed among the four neurosurgeons and are often discussed as part of a multidisciplinary conference. All oncology cases, for example, are discussed at a multidisciplinary conference that includes not only neurosurgeons, but oncologists, neuro-oncologists, radiation oncologists, neuro-pathologists and radiologists. A similar approach is used to guide the management of patients with complex congenital malformations of the spinal cord. In order to develop the best expertise to ensure optimal management of complex conditions, particularly those that are less common, individual neurosurgeons have developed special expertise in the treatment of specific disorders. For example, Dr. Steinbok offers expertise to patients with craniopharyngioma, epilepsy, cerebral palsy, and moya moya disease; Dr. Cochrane congenital malformations of the fetus, complex spina bifida patients and pineal region tumors and Dr. Singhal, expertise for those needing epilepsy surgery and adults with spina bifida.
The Division of Pediatric Neurosurgery has an ongoing quality assurance program, with regular assessments of complications, mortalities and outcomes. Our Division has consistently had among the shortest postoperative stays in Canada for a variety of neurosurgical conditions, including major craniotomies and shunt procedures, attesting to the low rate of postoperative complications. We also have one of the lowest rates of pediatric neurosurgical operations per unit population in North America, and this in part reflects the careful thoughtful approach of the neurosurgeons to the management of neurosurgical conditions and the ability of the neurosurgical team to achieve enduring results. We have achieved the lowest rates of blood transfusion in the world for open procedures to correct various types of craniosynostosis.
The Division of Pediatric Neurosurgery is part of the Division of Neurosurgery at the University of British Columbia. The neurosurgeons have a major role in the education of medical students and residents in the Neurosurgical training program at UBC. In addition to residency training, the Division provides a 1 year fellowship for fully trained neurosurgeons, who wish special additional training in pediatric neurosurgery. This fellowship has been accredited by the Accreditation Council for Pediatric Neurosurgery in the United States of America. Up to this time, the Division has trained fellows and students from North America, Sweden, Brazil and Northern Ireland.