Orlando Health fetal surgery program opens
Less than a year after Orlando Health revamped its pediatric neurology and neurosurgery programs, the health system is ready to perform its first fetal surgery case, becoming the first in Florida and one of the few in the Southeast to do the sophisticated, high-risk spina bifida surgery.
The hospital hired an experienced fetal neurosurgeon Dr. Samer Elbabaa to establish a fetal spina bifida surgery program and put together a multi-specialty fetal therapy team to coordinate the care of moms who are pregnant with babies that have minor or major congenital defects. Some require minor interventions, while others are candidates for surgery.
“It takes time and teamwork, and it has be taken very seriously,” said Elbabaa, director of pediatric Neuroscience Center
“Surgery is the difference between [a] wheelchair and walking with braces and then independently.” Dr. Samer Elbabaa, fetal neurosurgeon
of Excellence at Arnold Palmer Hospital for Children. “There’s no room for error.”
Fetal surgeons like Elbabaa operate on the baby before it’s born. Elbabaa specializes in repairing spina bifida, a neural tube defect that can damage the baby’s spinal cord, affecting about 1,500 babies each year.
The surgery can be performed after the baby is born, but a landmark study in 2011 showed that babies who had their surgery before birth fared better than those who did after birth. Many children in the latter group are not able to walk, can develop gastrointestinal and bladder control problems, or have fluid build-up in their brain.
“Surgery is the difference between [a] wheelchair and walking with braces and then independently,” said Elbabaa.
Ashley Barrett found out at 20 weeks that her baby boy had spina bifida.
“I hadn’t heard of the surgery before, and I couldn’t even believe it when I heard it,” said Barrett, 35. “But the moment I heard about it, that’s immediately what I wanted to do. For me, the benefits outweighed the risks.”
Elbabaa and his team were close to launching the fetal surgery program at Orlando Health, and Barrett, who works at Orlando Health South Lake Hospital, volunteered to be the first patient. But Elbabaa hesitated.
“For many of the 60 cases I had done, we had people visiting before going to their hospitals to do their first case. I wanted our team to see it first too,” Elbabaa said.
So the team told Barrett it would be best for her to have the procedure in Kansas City, where Elbabaa’s former partner was performing surgeries. And they asked her if they could go along to watch it.
On a snowy day in December, with Elbabaa and his team looking on in the operating room, Barrett and her baby had the surgery.
“They had everything so well-planned, and for every possibility, they had an answer or action plan. It was inspiring to see them do it,” said Dr. Cole Greves, a maternal fetal specialist who initially diagnosed Barrett’s baby’s spina bifida and will be involved in future fetal surgeries.
In total, Barrett and her husband spent almost three weeks in Kansas City. They left their 2-year-old daughter, Scarlett, with family in Orlando.
“That’s why I think it’s such a big deal to have this [program] here because a lot of people can’t travel that far. Some women have to stay at the surgery site until delivery time. I can’t imagine having had to stay [in Kansas City] that long,” Barrett said.
Her son, Maxwell, was born at 37 weeks in March via a planned C-section.
Soon after, her newborn was kicking his legs
“This is the dream outcome for me,” said Elbabaa. “The mother made it through the pregnancy with no emergencies. The baby is moving his legs, and the brain pressure is good, which means no shunts.”
Maxwell might need some braces at the beginning, but he’s expected to walk.