Surgical Tribune Europe

Doctors perform surgery on baby attached to placenta

By Surgical Tribune
August 02, 2012

TEL HASHOMER, Israel: Surgeons at the Sheba Medical Center in Israel have performed a rare procedure called extrauterine intrapartum treatment (EXIT) to save the life of a baby. This surgery is done outside the womb while the birth is still in process.

According to the online edition of the Israeli newspaper HAARETZ, the baby was still attached to the placenta during the life-saving operation. His mother, 30 weeks pregnant, had been diagnosed with excess amniotic fluid and the foetus had a life-threatening blockage in its breathing passages.

As the experts at the Sheba Medical Center feared that the baby could die before they were able to perform an operation after birth, they chose to carry out a procedure that—according to HAARETZ—has only been carried out a handful of times over the last decade, all at major Western hospitals.

The surgery was performed during a Caesarean section, once the baby’s head and shoulders had emerged. After they were unable to insert a breathing tube, the surgeons extracted one of the baby’s arms from the womb in order to administer an anaesthetic. He was then removed for a tracheostomy.

The baby boy remained attached to his mother’s placenta via the umbilical cord, which enabled him to continue to receive oxygenated blood.

The EXIT procedure requires careful coordination between the mother’s physicians and the specialists operating on the newborn. The difficulty lies in preserving enough blood flow through the umbilical cord, protecting the placenta, and avoiding contraction of the uterus so that there is sufficient time to establish breathing.

According to HAARETZ, 30 medical staff participated in the surgery, including ten doctors from different specialties. The entire operation took only 12 minutes, owing in part to a “dress rehearsal” by the medical staff beforehand.

The baby is in a stable condition in the hospital’s neonatal intensive care unit.

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