Many of the children Pediatric Neurosurgeon Dan Guillaume, MD, treats have incurable diseases.
This could be frustrating or disheartening for some, but Guillaume—chief of the division of pediatric neurosurgery for University of Minnesota Health—finds it motivating.
“We work with researchers to improve the care we deliver and to develop effective treatments for diseases for which no cure currently exists,” Guillaume said. “Being part of an academic health center means we can also think outside of the box and develop innovative therapies for incurable conditions.”
We sat down with Guillaume to discuss his work helping to advance neurosurgery.
Describe your role within M Health. What interests do you bring to patient care?
I am the chief of the Division of Pediatric Neurosurgery and an associate professor in the Department of Neurosurgery. My major interests are in brain tumors and complex hydrocephalus, and after my residency I obtained specialized training in minimally invasive neurosurgery and neuro-endoscopy. Minimally invasive and endoscopic neurosurgery involve operating through very small openings in the skull, or going through the nose to access compartments within the brain with the aid of an endoscope. An endoscope is a narrow tube that has a high-resolution camera and light at the tip, as well as working channels for surgical instruments. In many cases, we can obtain the same result by operating through a tiny opening rather than a large incision and this means less pain for the patient and a shorter hospital stay.
How do you help pediatric neurosurgery patients achieve the best possible outcomes?
Our major goal is for our patients to receive the safest and best care in the nation. We use continuously measured quality and safety data to improve the care we deliver. To make our operations safer and more effective, we use innovative imaging, neuro-monitoring, image-guided surgery and other forms of leading-edge technology. We also improve the quality of care we deliver with use of systems-based techniques and evidence-based clinical protocols.
Are most pediatric neurosurgical conditions diagnosed before the child is born, or not? Is there any implication to treatment or outcomes when the diagnosis is made earlier in life?
Although most pediatric neurosurgical conditions are diagnosed after birth, there is a trend toward diagnosis earlier and earlier in life. In some cases, the diagnosis is now made even before the baby is born. This shift is largely due to increased use and improved quality of prenatal imaging, and a better understanding of diseases that can be diagnosed before the child is born. We can now diagnose problems such as hydrocephalus and different types of spinal dysraphism, which is a congenital malformation of the spine that can lead to problems with leg movement, bowel and bladder function and brain development. Earlier diagnosis often means we can plan and treat the patient earlier, and halt ongoing damage to the central nervous system.
What words of confidence and hope do you tell parents whose child needs to undergo brain surgery?
Because of technological improvements, advances in understanding of neurological disease and specialized training in advanced techniques, most neurosurgical operations are safe. Serious complications like brain damage from a procedure itself are becoming rare. Much of this has to do with technology, including improved preoperative functional brain imaging, image-guided neurosurgery and neuro-monitoring, which allows us to conduct real-time tests of the central nervous system as we are operating.
What do you respect about the University of Minnesota Health community?
I have a huge amount of respect for my colleagues in the various M Health departments. I am surrounded by expertise in every single area by clinicians who are approachable, available and who have devoted their lives to improving the lives of their patients. There is never a shortage of brilliant minds and hard-working individuals to help solve a clinical dilemma.
What makes your work memorable? Are there any specific moments you often recall?
Many of the children I care for have incurable diseases, like brain cancer. Although this can be frustrating, it is also motivating. We work with researchers to improve the care we deliver and to develop effective treatments for diseases for which no cure currently exists. Being part of an academic health center means we can also think outside of the box and develop innovative therapies for incurable conditions.