World-first lung surgery while she was still in her mother’s WOMB

World-first lung surgery

A baby’s life was saved by pioneering surgery after doctors carried out an operation on her lungs while she was still in her mother’s womb.

Alaitz Corominas, from Spain, is now a happy and healthy toddler after becoming the world’s first foetus to undergo the procedure three months before she was due to be born.
The 16-month-old girl, who weighed just 1lb 10oz at the time, had only a 10 per cent chance of survival if surgeons in Barcelona had not fixed her blocked bronchial tubes.

Experts inserted an endoscope – a camera-ended tube that surgical instruments can fit through – into her mouth and then down her windpipe and into her lungs. An image of her lungs was then beamed on to a giant TV screen in the operating theatre and confirmed that she was suffering from bronchial atresia.

This where the bronchi – the air tube leading from the trachea to the lungs – do not properly connect with the central airways, meaning breathing is almost impossible.
Surgeons from two institutions – Hospital Clinic and Joan de Deu – reconnected the bronchial tubes on the right lung to her central airways in a procedure lasting just 30 minutes.
‘In such cases, you have to operate quickly, like a bank robbery,’ said Eduard Gratacos, who led the surgery.
However, they had to be extremely delicate because the procedure is carried out near the heart on ‘tissue as thin as cigarette paper’, Dr Graticos added.
To complicate things further, the heart is at risk of filling with liquid and can require restarting. Luckily this did not happen.
At the time of the operation, Alaitz, whose name means ‘Joy’ in her parents’ native Basque language, was operated on during her mother’s 26th week – or six-month mark – of pregnancy.
She went on to nearly complete a full nine-month term and was born in November 2010 weighing 5lb 8oz.
Grinning, waving and proudly walking, Alaitz, appeared in public for the first time yesterday along with her parents at a press conference held at the Hospital Clinic.
‘She is completely normal. She wakes up happy, she laughs if she is pleased, she cries if she is hungry,’ he mother, Monica Corominas, 33, said.
‘It was the only option. We either tried it or put an end to the pregnancy.’
Dr Gratacos, the head of the maternal-fetal medicine department at Clinic, told the AFP news agency: ‘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.
The expert team of doctors also included Josep Maria Martínez, Montserrat Castañón and Julio Moreno.
‘If we hadn’t operated on her, she would have died,’ Dr Moreno, a neonatologist at Sant Joan de Déu hospital, told Spain’s El Pais newspaper.
He said Alaitz was now expected to live ‘a completely normal life’.

Doctors discovered a problem with her lungs after a routine ultrasound examination to check the baby’s health.
They decided to act swiftly because the likelihood of her surviving without an immediate operation was so slim.
But while the Hospital Clinica is one of the top five centres in the world for foetal surgery, such a procedure on her lungs was particularly risky and had never successfully been carried out before.
Usually, prenatal operations are carried out on unborn babies with hernias and heart conditions.
Even in the U.S., where these surgeries are most common, only 600 babies a year are typically operated on and are often not successful.
Prenatal surgery is similar to other operations, except that the foetus remains dependent on the placenta.

After 30 weeks, doctors prefer to operate on the baby outside of the uterus as it is less complicated.
But Alaitz’s case, she was too young to be removed and would be is unlilely to have survived on the outside, even if they had operated on her lungs.
One of the main dangers is the risk of triggering early labour. This is why the task had to be carried out so quickly.
However, it means that surgeons can only concentrate on one task and often means that other problems cannot be dealt with.
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 their removal will not affect her health and quality of life.


Leave a Reply

Your email address will not be published. Required fields are marked *