Surgery in 6-week-old

A six-week-old infant, who weighed 3kg, arrived at Schneider Children's due to gradual weight loss and frequent vomiting which started after her birth. Following imaging studies, suspicion was raised that she was suffering from a developmental defect of the diaphragm during pregnancy which caused a portion of her stomach to protrude into the chest cavity, rather than be located in the abodominal cavity in its entirety. This led to pressure on her heart and lungs resulting in weight loss, vomiting and often, even a twisted stomach – an emergency and dangerous situation which could lead to life-threatening gangrene.

For the first time, surgeons used an innovative network to regulate gas pressure flowing into the abdominal cavity during surgery. Continuous use of the gas regulator prevents accumulation of bicarbonate oxygen that can lead to abnormally high pressure on the internal organs. Small children with low weight are much more sensitive than adults to fluctuations in pressure during laparascopic surgery (minimally invasive procedures). The regulator accords steady maintenance of pressure throughout the whole procedure, thus minimizing prolonged absorption of bicarbonated oxygen into the soft tissues.

Upon her arrival in the Surgery Department, director Dr. Dragan Kravarusic and his team decided to conduct laparoscopy to correct the defect in her diaphragm. Minimal invasive surgery does not leave a scar, nor does it require an incision in the abdomen. Recovery is is also much quicker and shorter.

The operation accorded a "rendezvous" between gastroenterology and surgery by combining innovative techniques with advanced technologies. Surgeons were assisted by cameras used in both disciplines during surgery, promoting precise diagnosis. The complicated surgery - planned down to the last move – included an examination by senior gastroenterologist Dr. Ari Silvermintz to identify the exact location of the stomach, as well as fluoroscopy (screening) of the swallowing mechanism which was performed by imaging technicians to verify the proper anatomical position.

Participating in the procedure were surgeons Dr. Kravarusic, Dr. Antastasia Almog and Dr. Yael Dreznik, who released the connections between the stomach, heart lining and lungs, thus restoring the anatomy of the esophagus and stomach while repairing the diaphragmatic defect. Close monitoring of the infant during the procedure was performed by head anesthetist Dr. Yelena Zeitlin. The surgery was completed without any complications and the infant began to breathe and eat on her own a day later.

Dr. Kravarusic noted that "we are happy with the outcome following close teamwork and cooperation between the various disciplines to ensure a successful result for the infant and her family. First-time use of the gas regulator network represents a leap forward in every sphere where maximum focus is on the health and safety of the patient during surgery. The Surgery Department is punctillious in introducing new technologies and utilizing tools that promote optimum precision when performing operations."

The Pediatric Surgery Department at Schneider Children's utilizes a range of surgical solutions to repair an array of complex disorders. The department supports and develops minimally invasive procedures for operations in the abdominal and chest cavities as well as in newborns and premature infants. Laparoscopic surgery is preferred from the standpoint of function and aesthetics, and requires highly advanced devices and skilled teams of surgeons and anesthetists.