Orlando Health is revamping its pediatric neurology and neurosurgery programs at its Winnie Palmer and Arnold Palmer hospitals in downtown Orlando, aiming to offer state-of-the-art procedures, such as fetal surgery.

To lead the multiyear effort, the health system has brought on board pediatric and fetal neurosurgeon Dr. Samer Elbabaa, who specializes in repairing spinal anomalies in unborn babies.

Our goal is to add expertise to treat the most complex conditions, in addition to focusing on coordination of care and research and education, said Elbabaa who arrived here three months ago from St. Louis, Mo.

The initiative adds another layer to the competition among the three childrens hospitals in Orlando, which, just by their sheer existence in a city this size, are an anomaly.

Florida Hospital currently boasts one of the most robust childrens neuroscience programs in the Southeast with the highest epilepsy surgery volume in Florida.

Nemours Childrens Hospital in Lake Nona has been recognized for its unique Muscular Dystrophy Association Clinic, led be world-renowned neurologist, Dr. Richard Finkel.

Elbabaas ultimate goal is for Winnie Palmer Hospital for Women & Babies to become a destination for spina bifida fetal surgery.

The condition is a neural tube anomaly. Each year, about 1,500 babies are born with it with various degrees of severity. Fetal surgeons like Elbabaa fix the defect in the fetus by opening moms pregnant belly.

Winnie Palmers program is at least a year away from accepting its first patient, but when open, it would be one of a first in Florida and one of the few in the Southeast, after Childrens Hospital at Vanderbilt in Tennessee.

In the meantime, Elbabaa has been working on establishing a coordinated system of care for kids with medical and surgical needs, ranging from brain tumors and epilepsy to autism and developmental delays.

He recently helped launch the Children Neuroscience Center of Excellence at Arnold Palmer Hospital for Children, bringing together various disciplines of pediatric neuroscience under one umbrella.

To further build the program, Arnold Palmer Hospital is planning to bring on board more pediatric specialists, including neuropsychiatrists, neurologists, psychologists and therapists for inpatient rehab. The center will eventually have its own physical space and an outpatient neurology clinic.

Creating a comprehensive multi-disciplinary approach to treating different conditions is a national trend. Florida Hospital and Nemours said they too have multi-disciplinary neurology programs.

Such programs can lead to better-coordinated care for patients. The model also allows hospitals to hire their own specialists, which can create competition for smaller, independent physician practices.

But thats not likely to happen for pediatric neurologists here because they are in short supply.

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There is a high demand and need for such specialized care, said Dr. Germano Falcao, a local independent pediatric neurologist. Its an underserved area, so they would be bringing additional resources here, said Falcao, who has privileges at Arnold Palmer Hospital.

Elbabaa is also gradually increasing the complexity level of pediatric surgeries to include skull-based and minimally invasive neurosurgeries at Arnold Palmer Hospital and eventually fetal surgery at Winnie Palmer Hospital, where more than 14,000 babies are delivered each year.

Im coming to a center with high volume of delivery, and this community deserves to have a fetal surgery program, he said.

Treating the fetus in the womb is a field thats constantly changing, spurred by individual innovators, hospitals and competition, according to the Society of Maternal-Fetal Medicine.

There are currently about two dozen institutions in the U.S. and Canada that perform more complex fetal procedures, many of which are part of North American Fetal Therapy Network. But there are other centers that perform basic fetal procedures, such as transfusions and shunts. Taken together, it would be reasonable to estimate that there approximately 50 programs across the country, according to Society of Maternal-Fetal Medicine.

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Similar to complex procedures like organ transplantation, parents usually have to travel to another state for fetal surgery.

Port Orange resident Elizabeth Watkins, for instance, decided to go to Childrens Hospital of Philadelphia last October, shortly after she found out that her unborn child had spina bifida.

The financial resources are a challenge, said Watkins, a social worker. She spent a month in Philadelphia, and after returning home, she was on bed rest until she delivered Scout six months ago at Winnie Palmer Hospital via Cesarean section.

Scout is a happy, healthy baby now, but she still needs close monitoring. Watkins has been driving regularly to Arnold Palmer Hospital to go to the Spina Bifida Clinic, where Elbabaa now cares for Scout.

We totally lucked out in getting him, she said. Having everyone together under the same roof benefits the parents and the patient, because everyone is on the same page.

Elbabaa also has his eye on the next generation of doctors and surgeons. He is planning to create learning opportunities for University of Central Florida medical students and eventually hopes to establish fellowships in pediatric neurology and neurosurgery.

We want to be a destination in which parents have confidence, he said. The community really deserves this.

nmiller@orlandosentinel.com, 407-420-5158 or @naseemmiller

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Orlando Health revamping pediatric neurology services - Orlando Sentinel