Thanks to advances in fetal surgery, Spina bifida, (“split spine”), a dreaded, devastating birth defect, can now be corrected in utero. Following the training of its multidisciplinary team in Brazil, the Hadassah Medical Organization will be the first to introduce this groundbreaking surgery in Israel.
Many parents who learn their unborn baby suffers from this defect make the heartbreaking choice to abort the fetus. Others, for whom abortion is not an option, face a future of raising children with severe physical and often cognitive problems that will plague them for their entire lives.
Traditionally, to close the backbone and membranes around the spinal cord, back surgery is performed on the first day of birth. The surgery, however, does not completely eliminate the physical disabilities.
In certain medical centers, alternatively, the fetus is removed from the mother before birth, operated upon, and then put back in the womb. “Removal of a fetus from the uterus involves many risks, both for the baby and the mother,” explains Dr. Moni Benifla, head of Hadassah’s Pediatric Neurosurgery Unit. Consequently, Hadassah had decided against performing that procedure. Now, however, the option to perform the surgery in utero has become a possibility.
Hadassah already has an outstanding Fetal Medicine department, headed by Dr. Yuval Gielchinsky, a world-renowned expert and so-called “twin whisperer,” who has saved hundreds of babies--many of them twins who shared a blood supply--by operating on them in utero.
Dr. Gielchinsky, Dr. Benifla, and Anesthesiologist Yehuda Ginnosar have completed their initial training in Sao Paulo. The three comprise a powerful team because, as Dr. Benifla explains: “My experience as a pediatric neurosurgeon who works with endoscopy in the delicate areas of the brain is vital. Dr. Gielchinsky and Dr. Ginnosar have enormous experience in fetal surgery.” He adds: “We chose Brazil for training because abortion is uncommon there and there are more cases of Spina bifida.” The Hadassah team, expanded to include an operating room nurse, will make one additional visit to Brazil before returning to Hadassah to launch the surgery at the beginning of 2016.
Looking ahead, Dr. Benifla relates: “We expect to have at least one case a month from Israel and the surrounding countries because we have a traditional population where abortion is often not a religious choice.”