Operative Volume of Newborn Surgery in German University Hospitals: High Volume Versus Low Volume Centers

Analysis of operative volume for 10 index neonatal procedures across 19 German university hospitals (2015-2017) reveals significant decentralization, with 58% classified as low-volume centers treating only 51% of expected nationwide cases. The study demonstrates that most congenital malformations are distributed across multiple centers rather than concentrated in high-volume institutions, raising concerns about surgical experience, training quality, and the need for care centralization.