CLEVELAND, Ohio – The Cleveland Clinic has joined other top hospitals in North America and can now offer uterine surgery. The hospital announced Wednesday that after more than a year of preparations, Nordohio's first surgery on a fetus in the uterus to successfully repair spina bifida was successfully completed.
"The operation on the fetus in the uterus is led and led by Darrell Cass, director of fetal surgery at the Cleveland Clinic's Fetal Center.
Cass and a team of more than a dozen other specialists, including pediatric neurosurgeons, a fetal cardiologist and pediatric anesthetist, performed the surgery in February on a nearly 23-week-old fetus with the birth defect spina bifida.
The baby was born on June 3rd, with almost 37 weeks. Mother and baby are fine. In a fetus with spina bifida, the tube, which normally protects the lowest part of the spine, does not close and the spinal cord remains free. This leads to a variety of problems.
"Spina bifida causes disability in a baby. This can lead to paralysis of the legs, it can affect their ability to urinate, Cass said. "A build-up of pressure and fluid and that pressure can damage the brain."
A fetal surgery for a birth defect is currently an option for parents in approximately 20 hospitals in North America after clinically accepting them in 201
Cass has performed more than 160 fetal operations since 2002 and was co-director of the Texas Children's Fetal Center in Houston after 17 years. He joined the Cleveland Clinic to begin the fetal surgery program. He and his team spent more than a year preparing for the first operation.
"We began with simulations and surveys and with preparations for how the operations would progress," Cass said.
The team also visited other fetal surgery centers around the country to learn from the leading experts in the field, "We open the uterus in the slightest way directly above the point where the baby's back is," said Cass. The team uses ultrasound to constantly monitor the position of the baby during surgery.
Doctors repair the baby's spine through a mere 4.5 centimeter wide opening in the uterus.
After completing the operation, "the spinal cord is completely protected". Said Cass. "It's covered with muscle and skin, which is called myofascial repair, which is the current state of the art."
Cass said the operation was extremely risky for the baby. There is a possibility that the mother will give birth to the child immediately weeks after surgery.
But in this case, the mother carried the child almost to birth, 36.5 weeks, to better develop the baby's brain before it was born by caesarean section.
"The operation was flawless. In fact, repairing the back of this baby is the best I've seen in the last 20 years," said Cass.
Spina bifida can not be completely cured, but the little girl will have less disabilities and a much better future and quality of life than if she had been treated after her birth.
"She will still be struggling with disability and we will work on all these things, but she will be as good as she can," said Cass.