Ground-breaking Australian-first surgery was performed at the Mater Hospital on Saturday with surgeons performing prenatal in-utero surgery to treat a fetus with spina bifida.
The team from The Mater led by director maternal fetal medicine Dr Glenn Gardener was joined by expert surgeons from Vanderbilt University Hospital in the USA, who have been performing this type of surgery since 1997.
The operation involved making an incision in the mother’s abdomen to access the uterus, then making an incision to reach the lower back of the fetus to correct the abnormality associated with spina bifida.
Dr Gardener said the surgery was widely available in the United States and Europe but this was the first time it has been performed here.
“It’s never been done in Australia before,” he said.
“The team that we had from Vanderbilt University Hospital have done more than 300 operations of this kind, it is reasonably common in the US and its available in Europe but it’s not available in Australia for patients whose babies are diagnosed with spina bifida.”
Dr Gardener and members of the team who performed the surgery from the Mater travelled to the United States to watch the procedure being done before raising funds through the Mater Mother’s Auxilliary to bring the team of surgeons from Vanderbilt to Australia to assist with the first operation of its type here.
The team of doctors and nurses practiced the procedure in drills on Friday running through possible emergency scenarios they might face before making the decision to go ahead with the operation on the patient on Saturday.
“Both teams from the Mater and Vanderbilt were very comfortable working together,” Dr Gardener said.
“We all agreed that we were ready to proceed with operation after we had gone through the drills and the operation was extremely smooth for both mother and baby.”
The patient was the mother of a baby that had reached the 24-week gestation mark, coming inside the very tight window available for surgeons to perform the procedure.
“The surgery needs to be performed during the 22nd and 25th weeks,” Dr Gardener said.
“Most cases of spina bifida are diagnosed at the 18-20 week scan so that gives the doctors and the patient a few weeks to consider whether it is an option for them or not.”
In-utero surgery carries risks for both the mother and the baby but Dr Gardener said an extensive study in the US showed that the positive outcomes of prenatal surgery on spina bifida were incredibly successful.
He hopes the team at the Mater will be able to make the surgery more widely available to patients in Australia and possibly expand the availability to New Zealand and South East Asia.
“We hope to be able to attract some more cases now that we have performed the surgery,” he said.
“The future is that if those numbers are enough to keep our skills up we will be able to continue into the future and potentially offer an option for patients in New Zealand and South East Asia where this procedure isn’t available.”
Dr Gardener said to his knowledge only two Australian patients had travelled overseas to access the surgery, with most parents opting to have the surgery performed after birth.
He said the procedure was unique for the doctors at the Mater.
“It’s different to any other surgery that any of us practice in our day to day lives,” he said.
“This saw five speciality teams coming together sharing in this case.”