First Time in Israel

Since birth, Omer 3½-year-old had suffered from difficulty in breathing, with chronic lung infections requiring frequent hospitalizations due to a congenital defect in his trachea and alimentary canal – a fistula between his windpipe and esophagus, and esophageal atresia. This disorder appears in 1:3000 children, some of whom require surgical intervention. Up until now, the special technique was only performed in Boston Children’s Hospital, USA. It was recently introduced into Israel and will improve the quality of life of many children in the future. Omer is one of three children who first underwent this type of surgery in Israel.

About a year ago, specialists from the Aerodigestive Clinic (joint ENT and Gastroenterology) at Schneider flew to Boston Children’s to study innovative tracheopexy under Dr. Russell Jennings, who developed the surgical technique to repair the trachea and significantly improve the condition of children suffering from severe tracheomalacia. The team from Schneider included senior pulmonologist Dr. Patrick Staffler, senior surgeon Dr. Emanuel Segeya, and Dr. Gabi Amir, cardiothoracic surgeon.

At the beginning of October 2019, a team of 6 doctors from Boston Children’s arrived in Israel to train Schneider doctors how to perform these unique procedures. During their visit, 3½-year-old Omer underwent a 13-hour operation by a joint team of American and Israeli surgeons. He was subsequently transferred to the Pediatric Intensive Care Unit for observation and recovery, and was discharged a week later. He has made a speedy recovery and will soon return to kindergarten. The surgery will significantly improve his quality of life and that of other children who no longer need to travel to Boston for the operation. The medical teams in Boston and Schneider Children’s have remained in close contact through video-conference calls to discuss complex cases.

Schneider Children’s opened the Aerodigestive Clinic in 2017, the first of its kind in the country. The clinic aims to provide comprehensive care to children and adolescents with complex health issues involving the airway passages and the alimentary canal such as lung infections due to aspiration, esophageal movement disorders, laryngeal clefts, paralyzed vocal cords, fistulas between the esophagus and trachea, and more.

The joint approach has more than proven itself in speedier diagnoses alongside precise diagnostic treatment. Based upon medical need, the team conducts joint repair including several procedures under one general anesthetic such as flexible and rigid bronchoscopy and gastroscopy in the presence of the anesthetist skilled in airway control during these complex procedures. The team is frequently able to make a diagnosis missed at other centers due to joint collaboration and teamwork.

Due to the complexity of cases, the multidisciplinary clinic includes specialists from pulmonology, gastroenterology, nutrition and liver diseases, ENT, surgery, occupational therapy, anesthesiology, imaging, physical therapy, and dietary services. The team utilizes an all-encompassing approach integrating the various disciplines to provide the child with comprehensive care all at the same time. This approach is called clinical care coordination, and was developed more than two decades ago by Cincinnati Children’s Hospital in the USA, and adopted by Schneider Children’s.

The team comprises Dr. Patrick Staffler, founder of the clinic; Dr. Ari Silbermintz, gastroenterologist; Dr. Yoram Stern and Dr. Moshe Hain, otolaryngologists; Dr. Sylvia Gruzovsky, radiologist; Yulia Genedler, head nurse in the Institute of Pulmonology and clinic coordinator; Yifat Nitzan, communication clinician; Adi Shimoni, occupational therapist; Tami Schneiderman, physical therapist; Yifat Fisher, dietician; and Orian Lusne, secretary.