A pioneering procedure carried out by a South African doctor working in Texas could eventually be performed in South Africa, according to the surgeon who was on a visit to Cape Town last week, reports EWN.
Michael Belfort, Chief of Obstetrics and Gynaecology at Texas Children’s Hospital, headed up the team that operated on 26-week old baby Theo while he was still in the womb, and who had gastroschisis – a birth defect in which the intestines grow outside the body.
Belfort told CapeTalk the surgery was originally developed to treat spina bifida. He said after almost 10 years of treating patients with spina bifida, the move to treat those with gastroschisis was a natural progression.
The surgery itself begins with an incision on the mother’s abdomen, similar to the one performed during a Caesarean section.
“We then elevate the uterus out of the abdomen into the surgical area and support that, and then position the baby, remove the amniotic fluid, and replace that with heated and humidified carbon dioxide gas.”
Belfort said the technology is similar to that used in laparoscopic surgery, except the instruments used are much smaller.
"Our instruments are only two millimetres in size, so they’re very, very small: we put them through little ports into the uterus, before pushing the bowel back inside and suturing it up.”
Belfort said the team had already performed the procedure on babies from Brazil and Mexico before Theo became the third patient.
The operation itself was part of a highly regulated clinical trial and followed years of research, animal studies and simulations, he added.
“This particular surgery has taken us ten years to go from concept. When I very first came up with this idea and went to our paediatric surgeon, he told me he thought it was a stupid idea!”
While, as with any surgery, there are risks, Belfort said it could significantly reduce the amount of time similarly affected babies might otherwise spend in neonatal intensive care, and believes the procedure could eventually be performed in South Africa.
He added that the technology and expertise already exist here and the main challenge was compiling the right team and resources.
EWN article – South African doctor in USA leads pioneering surgery on baby in womb (Open access)
See more from MedicalBrief archives:
Ground-breaking operation on spina bifida foetus
US team led by SA-trained doctor in an African first
Association between day of delivery and maternal foetal mortality