Department für Neurochirurgie und Neurotechnologie
Universitätsklinik für Neurochirurgie

Report on clinical activities at the department of neurosurgery, university hospital tübingen, under the wfns-aesculap adult fellowship program

Dr Campbell Francis Chukwuebuka MBBS, FWACS, MRCS (England)

WFNS clinical fellow ( April-June 2025)

This report details the clinical activities I undertook during the WFNS-Aesculap Fellowship at the Department of Neurosurgery, University Hospital Tübingen. The fellowship, generously supported by Aesculap, aims to provide young neurosurgeons, particularly from developing countries, with comprehensive exposure to advanced neurosurgical techniques and practices. The experience was a memorable one and an absolute turning point in my young career as a neurosurgeon. I arrived in Tübingen, Germany, on April 2, 2025, via Stuttgart Airport, and was welcomed by the beautiful scenery of the Alps as our plane descended into the landing strip. The Germans I encountered were exceptionally hospitable and willing to assist with any challenges you may face as a visitor. Tübingen is a traditional university city in central Baden-Württemberg, Germany. It is a typical student community with an immaculate environment and an excellent transportation system.

The Department of Neurosurgery at the University Hospital Tübingen is a leading neurosurgical centre in Germany. It boasts state-of-the-art facilities and performs complex neurosurgical interventions across a broad spectrum of neurosurgical subspecialties. I was warmly welcomed on my first day by the departmental secretary, who gave me a tour around the facilities and introduced me to other staff members. The department comprises various subspecialties in neurosurgery, including skull base, vascular, pediatric, functional, and oncology, and is renowned for its cutting-edge research and exceptional patient care. The daily activities typically begin with morning meetings, starting at 7:15 am, during which all patients scheduled for surgery are discussed, including the emergency cases and those in intensive care. In the meetings, an in-depth analysis of the cases, including surgical approaches and decisions, was made by all staff, including senior faculty members.

The theatre session runs from Monday to Friday, and about 12-17 cases are operated daily. The theatres are equipped with advanced surgical armamentarium, including intraoperative MRI and CT scanners, the latest Karl Zeiss microscopes, various brands of endoscopes, and a robotic machine for stereotactic biopsies, among others. Patient care is evidence-based, utilizing the latest technologies to achieve excellent surgical outcomes. I observed the remarkable synergy between the various theatre staff, who aimed to achieve smooth operations and excellent outcomes. I actively participated in numerous procedures, and we typically had a brief discussion with the lead surgeon before the surgery and some debriefing at the end of the operation. Various skull base approaches, including retrosigmoid craniotomy for vestibular schwanomma and petroclival tumours, aneurysm clipping,  surgeries for intra-axial tumours, including glioblastoma and metastasis. Various spinal operations, both open and minimally invasive, were performed by the team. The outstanding aspect was the resident-centred approach, where a junior member of the team performed the initial part of the surgery, and subsequently, the senior faculty member scrubbed in to perform the more complex part of the operation.

The department also holds regular weekly academic meetings and seminars.    I attended the tumour board meetings, held on Tuesdays and Thursdays afternoons, which involve teams from various subspecialties managing patients with tumours of the craniospinal axis. In addition, the department holds monthly morbidity and mortality meetings, surgical audits, and other departmental seminars, which collectively make the training in the department robust. It is customary for international fellows to give a presentation in the department about their home countries and the peculiarities of neurosurgical practice, which I did during the latter part of my stay. 

I paid a visit to Aesculap AG in Tutlingen, which was my sponsor for the fellowship program. Aesculap AG is the largest company in Tuttlingen, Baden-Württemberg, Germany, and it manufactures medical devices and medical intervention technology. During the tour around their facilities, we were shown how various surgical instruments were produced from the raw material base to the finished product. Most notable is the production of aneurysm clips, which involves the highest level of precision and craftsmanship. Aesculap's array of products spans various therapeutic fields, including minimally invasive surgery, orthopaedic joint replacement and regenerative therapies, spinal surgery, neurosurgery, interventional vascular diagnostics and therapy, sterile goods management, as well as sutures and surgical specialities. They believe in quality production and maintaining the highest possible standard and quality assurance. 

  The department made arrangements for accommodation before my arrival, which was a short distance from the hospital, making the commute very easy. The accommodation provided was very hospitable and contained all the necessities to make my stay comfortable. I also visited some memorable tourist sites within and outside Germany. This includes the Ulm Minster, a Lutheran cathedral built in the 13th century, which was described as the tallest church in the world. I also visited the birthplace of Mozart in Salzburg, Austria, and toured the museum, which depicts the early life of Mozart and displays his first musical instruments. Additionally, I visited the residence museum in Munich, the famous Berlin Wall, and the Eiffel Tower in Paris, France. Visiting these popular and iconic sites was an unforgettable experience that allowed me to meet and make friends with other African students and tourists in Europe. 

The WFNS-Aesculap Fellowship at the Department of Neurosurgery, University Hospital Tübingen, has been an invaluable and transformative experience for me. The comprehensive clinical exposure, coupled with robust academic and research opportunities, has significantly advanced neurosurgical expertise. I want to express my profound gratitude to the World Federation of Neurosurgical Societies and Aesculap AG for their generous sponsorship and to Professor Tatagiba and the entire team at the Department of Neurosurgery for their mentorship, guidance, and unwavering support throughout the fellowship. I also want to acknowledge Ms Stefanie Hilcher for her support throughout the application process and ensuring that the fellowship went hitch-free. The knowledge and skills acquired will undoubtedly contribute to improving neurosurgical care in my country.