Spanish doctors announce world first in fetal surgery

March 13, 2012 by Marcelo Aparicio

When Alaitz was still a fetus in her mother's womb, Spanish doctors successfully operated on her lungs to fix a blocked bronchial tube in what they said Tuesday was a world first.

The fetus was suffering from a bronchial atresia, an anomaly where the bronchi, the air tube leading from the trachea to the lungs, do not connect properly with the central airways.

Staff from two Barcelona hospitals -- Clinic and Joan de Deu -- introduced an endoscopy through the fetus' mouth to connect the right bronchi with the central airways in a procedure done in late 2010 that was unveiled Tuesday.

"It is the first time in the world that this has been achieved. It is the first time that it has been tried and it turned out well," said the head of the maternal-fetal medicine department at Hospital Clinic, Eduard Gratacos.

"It is an extremely delicate operation since it is carried out near the heart on tissues as thin as cigarette paper. But without this fetal therapy, the baby would not have survived,"" he told a news conference.

Eleven weeks after the pioneering surgery Alaitz -- which means "joy" in the Basque language -- was born weighing 2.5 kilograms (5.5 pounds).

Wearing a red bow in her curly hair, Alaitz, who is now 16 months old, appeared in public for the first time at the news conference on Tuesday at the Hospital Clinic along with her parents.

"She is completely normal. She wakes up happy, she laughs if she is pleased, she cries if she is hungry," said Alaitz's mother, 33-year-old Monica Corominas.

"It was the only option. We either tried it or put an end to the pregnancy."

Bronchial atresia, affects one fetus in 10,000, said Gratacos. It usually leads to the death of the fetus in about 90 percent of all cases.

"Thanks to an ultrasound we detected the problem early. If we had not intervened, she would be dead," said Julio Moreno, a neonatologist at the Hospital Joan de Deu who took part in the operation.

The operation lasted just 30 minutes but was very delicate as it was carried out on a 26-week-old fetus weighing just 800 grams (28 ounces).

"In such cases, you have to operate quickly, like a bank robbery," said Gratacos.

"The parents reacted very well. The truth is that the mother showed great strength, as she saw no other option, she accepted the need for the surgery."

Thirteen days after Alaitz was born, she underwent an operation to remove two of the three pulmonary lobes of her right lung which were damaged by the malformation of her bronchi.

Doctors said the removal of the pulmonary lobes will not affect Alaitz's health and quality of life.

The Hospital Clinica is one of the five largest centres in the world for fetal surgery. It deals with 200 cases of fetal pathology per year.

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