Exhaustive Hours Provide Invaluable Knowledge In Healing

An Update on Dr. Fuchs’ E.U. Clinical Residency Fellowship at Université Paris-Saclay

PARIS, FRANCE – Since July, Dr. Juri Fuchs, a resident at Heidelberg University Surgery Clinic and a researcher with Liver Surgery Research Heidelberg (LSRHD), has been participating in a six-month E.U. Clinical Residency Fellowship at Université Paris-Saclay. Based at the Center for Pediatric Liver Transplantation and Hepatobiliary Surgery, Hôpital Bicêtre, Assistance Publique - Hôpitaux de Paris (AP-HP), Dr. Fuchs has focused on clinical training in pediatric liver transplantation and hepatobiliary surgery, as well as research into rare liver diseases in children.

The primary objective of the fellowship is to gain hands-on experience in surgical techniques and perioperative care for children with liver diseases. Dr. Fuchs is particularly interested in addressing conditions such as biliary atresia, liver tumors, bile duct cysts, and other rare liver disorders. These conditions are treated with notable frequency at Hôpital Bicêtre, where procedures such as Kasai portoenterostomy, split liver transplantation, and major liver resections for infants—especially those under one year old—are commonly performed.

Hôpital Bicêtre handles an exceptionally high volume of unique and rare liver disease cases. However, the relatively low number of surgical residents allows Dr. Fuchs to actively participate in numerous operations. In some cases, he is even entrusted with performing portions of surgeries under the guidance of senior surgeons. Dr. Fuchs has assisted in liver transplants, complex hepatobiliary surgeries, oncologic procedures, and neonatal surgeries. As an operating surgeon under supervision, he has independently performed procedures such as inguinal hernia repairs and appendectomies.

However, assisting in the operating room (OR) is just one aspect of Dr. Fuchs’ responsibilities. His duties also include evening and overnight ER (Emergency Room) shifts, where he manages pediatric emergencies ranging from wounds and fractures to postoperative complications. Additionally, he oversees patient care in hospital wards, conducting rounds twice daily, coordinating with senior surgeons, changing bandages, removing drains, addressing patient health crises, and ensuring preoperative and discharge procedures are properly completed. Administrative tasks, including meticulous documentation, are integral to his role for tracking patient care and recovery.

Despite his demanding schedule, Dr. Fuchs continues to conduct research. His recent study, “Biliary Rhabdomyosarcoma in Pediatric Patients: A Systematic Review and Meta-Analysis of Individual Patient Data,” was published in Frontiers in Oncology, Pediatric Oncology. He is also working on retrospective analyses and meta-analyses addressing topics such as extended liver resections in pediatric patients, rare aggressive liver tumors, and biliary atresia subgroups.

The fellowship’s intensity reflects a broader challenge faced by hospitals worldwide: the shortage of surgical residents and attendings. While the workload is demanding, it provides Dr. Fuchs with invaluable learning opportunities, particularly in perioperative management of pediatric patients, advanced surgical techniques like split liver transplantation, and complex procedures such as liver resections in infants. He has gained expertise in evaluating indications for pediatric liver transplantation, assessing organ quality, planning liver resections, and mastering principles of pediatric liver surgery.

Dr. Fuchs deeply values the opportunity to train at Hôpital Bicêtre, a center uniquely equipped to treat rare pediatric liver diseases. He hopes to apply the knowledge and skills gained during this fellowship to benefit children suffering from similar conditions.

Looking ahead, Dr. Fuchs plans to build on his experience, refine his surgical skills, and engage with the highly experienced surgeons at Hôpital Bicêtre before the fellowship concludes in December. He aims to perform more complex operations under mentorship and foster collaborations in scientific research.

After returning to Heidelberg University Surgery Clinic, Dr. Fuchs anticipates missing the complexity of pediatric liver surgery and the interdisciplinary work with hepatologists on pre- and post-transplantation therapies. However, he hopes to contribute to re-establishing a pediatric liver transplantation program at Heidelberg, applying specialized techniques learned during his time in Paris.

Although the workload has been intense, Dr. Fuchs has found moments to enjoy Parisian life and immerse himself in French culture, significantly improving his language skills. Reflecting on his experience, he noted, “The workload is quite challenging, but I have learned so much about pediatric liver surgery in a relatively short time, which is extremely satisfying.”

The fellowship aligns with the broader mission of AP-HP, a leader in cancer care and rare disease treatment. With over one-third of all cancer patients in France treated at AP-HP facilities, the organization is renowned for its expertise in rare and pediatric cancers. To learn more, visit https://www.aphp.fr/pass-sanitaire-lhopital.

About Liver Surgery Research Heidelberg: Liver Surgery Research Heidelberg specializes in liver regeneration after hepatectomy, post-hepatectomy liver failure, HCC development and treatment (especially in the context of MAFLD), and rare liver diseases. The group is currently involved in over 24 research projects, with five articles under review and more than 100 published works. LSRHD also leads the RELIVE (RarE LIVEr) Initiative, a multidisciplinary effort to establish evidence-based therapies for rare liver diseases. To learn more, visit www.liversurgeryresearch.com.

Author: Nicholas Murtha is the Communications Manager at Liver Surgery Research Heidelberg. He holds a Bachelor of Arts in Political Science from the University of Minnesota.