Wonderful Engineering

Cleveland Clinic Conducts Its First Successful Fetal Surgery

The Cleveland Clinic has stepped into the league of the top hospital in North America that are offering utero surgery. The hospital announced on Wednesday that after preparations worth a year, it was able to successfully complete Northern Ohio’s very first surgery on a fetus inside the uterus to repair spina bifida.

Dr. Darrell Cass, Director of Fetal Surgery in the Cleveland Clinic’s Fetal Center, said, ‘The operation on the fetus in the uterus, I’m directing and in charge of, and the guidance of where we should open the uterus, the exposure of the baby.’ Dr. Darrell Cass, along with a team of specialists, carried out the surgery on a 23-week fetus with the birth defect spina bifida in February.

The baby girl was born at 37 weeks on June 3. Both the mother and the child are doing well. So, what exactly is spina bifida? A fetus with spina bifida has the tube that generally protects the lowest part of the spine, failing to close, thus causing the spinal cord to be exposed, resulting in a number of problems. Dr. Darrell Cass said, ‘Spina bifida leads to disability in a baby, it can cause paralysis of the legs, it can affect their ability to urinate. A build-up of pressure and fluid and that pressure can lead to brain damage.’

Fetal surgery for the birth defect is an option that parents can opt for in almost 20 hospitals in North America. The fetal surgery was clinically accepted in 2011. Cass has conducted more than 160 fetal surgeries since 2002. Cass said, ‘We started doing simulations and walk-throughs and preparations for how the operations would go how the family’s experience would be.’ The team also visited other centers where fetal surgery is conducted to learn from the experts in the field.

Despite the fact that the mother is doing well, she is not up for an interview as of yet. However, she has allowed the footage of the surgery to be released. Cass said, ‘We open the uterus in the smallest way directly over where the baby’s back is positioned.’ The team then repaired the baby’s spine via an opening in the uterus that was only 4.5 centimeters wide. Once the surgery was finished, Cass says, ‘her spinal cord is completely protected. It’s covered with muscle and skin; something called a myofascial repair, which is the current state of the art.’

Cass further said, ‘The operation went perfectly, and in fact, the repair on this baby’s back is the best that I’ve seen in the last 20 years. She will still have to deal with some disability, and we are going to work on all of those things, but she will be as good as she can be.’