We like to describe the simplest tasks in life by saying, “It’s not brain surgery.” But what about the tasks of an actual brain surgeon, in particular one who operates on children? “Neurosurgery can be incredibly complex,” says Michael DiLuna, MD, one of two pediatric neurosurgeons at Yale New Haven Children’s Hospital. “Though there have been great strides in our understanding of diseases and complexities of the brain and central nervous system, there remains much work to be done.”
DiLuna is perpetually hopeful that his patients—from infants to young adults—will have their whole lives ahead of them. “We want these children to have as much of a normal life as possible,” he says. “When I remove a brain tumor from a child, my goal is that this kid goes to her senior prom, gets married and has kids some day.”
As complicated and intricate as DiLuna’s tasks are, he works alongside a diverse team of other highly trained medical experts. “For a successful, safe operation with a good outcome, I need people from all specialties: anesthesia, oncology, neurology, genetics, plastic surgery, urology—all hands on deck,” he says. “It really does require a multidisciplinary group of specialists.”
Yale New Haven has had a dedicated pediatric neurosurgery program for more than 25 years. Common problems treated include hydrocephalus, brain and spinal cord tumors, spina bifida, craniofacial disorders, and brain or spine trauma. There also are many obscure diseases that might only occur once or twice in a decade. “Most are congenital anatomical anomalies that, as the child grows, will affect his ability to lead a normal life,” DiLuna explains. “We have to correct them early or the child will end up with problems later on. Sometimes patients require multiple surgeries, even into adulthood, so there cannot be an age limit to what we do.”
While DiLuna is constantly amazed at the bravery, optimism and resilience of his young patients, he understands that parents rely on him as well. “They have to get the sense that their child is in good hands,” he says. “I go into every operation feeling that I have to return that child back to the parents in better condition than before.”
This dedication to compassionate care is not all that differentiates the pediatric neurosurgery program at YNHCH. There’s cutting-edge technology, such as the operating room suite equipped with the most advanced MRI and angiography imaging device in the world. There also are minimally invasive surgical techniques that, for example, allow DiLuna to perform spine surgeries through small incisions and endoscopy, thereby reducing blood loss and recovery time.
Pediatric neurosurgery is indeed complex, although that’s part of the appeal to the specialists at YNHCH. “It’s a field of medicine where you truly feel you can have an impact,” says DiLuna, “and yet there’s still so much to be figured out to drive it forward.”
