HealthWatch: Surgery in the Tiniest Patients

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No parent wants to hear their child needs surgery, but a less invasive approach with smaller incisions would sure make going through it a whole lot easier. To make tiny incisions, you need tiny tools. 
Little Mateo is a healthy, happy two-year-old. 
But he had a rough start. Doctors found a growth on his lungs when mom was just 23 weeks pregnant. 
Jacob Harkins, Mateo’s Dad said, “You could feel the air come out of the room. It was just like ‘phooo’. Happy to like scared as you could imagine.” 
Florencia Vitaver, Mateo’s mom, said “We went home and consulted Dr. Google, and of course everything got way scarier.” 
He needed a lobe of his lung removed, a surgery he’d have at two months old.  
“It was heavy. It was really, really tough,” said Vitaver.
But Mateo was in skilled hands. Saundra Kay, MD, a Pediatric Surgeon at Rocky Mountain Hospital for Children and her colleagues are pioneers in minimally-invasive surgery for babies. 
Dr. Kay said, “Operating on a little baby is not the same as operating on a bigger person.” 
When laparoscopic tools first hit the scene, they were too big for babies. But those tools are getting smaller … giving the tiniest of babies a better option. 
“We’re talking five pounds and even less than that for some of the procedures that we do,” Dr. Kay said.
Dr. Kay’s partner, Dr. Steve Rothenberg, has developed small tools now used around the world, like this three- millimeter sealer to close tiny blood vessels. 
“These things really expand our capabilities,” Dr. Kay said.
It’s often an easier recovery. No big cuts mean no big scars. 
“They’re little mosquito bites. He has three little mosquito bites. It’s amazing to us. It’s so cool,” said Vitaver.
Surgeons at Rocky Mountain Hospital for Children train surgeons all over the world on their minimally invasive tools and techniques. During Mateo’s surgery, there were 27 doctors around the world watching. 
Contributors to this news report include: Stacie Overton Johnson, Field Producer; Rusty Reed, Videographer; Cyndy McGrath, Supervising Producer; Hayley Hudson, Assistant Producer; Roque Correa, Editor.

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MEDICAL BREAKTHROUGHS
RESEARCH SUMMARY

TOPIC:     SURGERY IN THE TINIEST PATIENTS
REPORT:    MB #4556

BACKGROUND: Congenital lung malformations form while a baby is developing in the womb. These lung problems may include cysts, solid growths, a mix of the prior two, or even a lobular emphysema (an airway to one section of the lung is blocked). Diagnosis before birth usually occurs when lung malformations are found on an ultrasound. Your healthcare team can monitor your baby’s condition, provide any needed treatments, and get ready for the delivery and care they may need after birth. These types of malformations rarely shrink prior to giving birth. Imaging studies may be taken to check the size of the malformations and watch for problems; fetal MRI’s or echocardiograms may be required. Surgery is almost always needed to remove the malformation, and helps your child avoid future problems. For most children with lung malformations, the outlook is excellent. For a fetus with congenital heart failure that leads to hydrops, the situation is on the more serious end. 
(Source: https://www.seattlechildrens.org/conditions/airway/congenital-lung-malformations/)  

BEFORE AND AFTER: Surgery can be stressful for babies, so it is important for caregivers to understand they may feel stressed but there are ways to help provide reassurance and comfort. Infants may feel anxiety or stress as a result of the separation from their caregivers and home environment, seeing many different medical professionals and strangers as well as strange sights, sounds, and smells. In the days prior to surgery, it’s important to keep the baby’s routine the same and make sure everyone is well rested for the day of surgery. Bring baby’s favorite security item or items to the hospital, to create a more familiar environment. Caregivers above all must try to remain calm, as babies can easily sense if they are frightened or stressed. After surgery, babies may be fussier or cry more during this stressful time, they may also become very clingy and become hard to console or comfort. Rest assured, with lots of reassuring and love, things will return back to normal in a short amount of time. 
(Source: https://www.choc.org/programs-services/surgery/preparing-infant-for-surgery/)  
 
NEW TECHNOLOGY: Hospitals are now able to perform minimally-invasive surgery on babies. Years ago, when the field of pediatric surgery first started, a lot of babies didn’t make it because surgeons didn’t have the proper tools to work on such small patients. Starting with open surgery, over the years, the technology and surgical tools have improved. Open surgery on infants, especially through the chest muscle, can cause major scarring and possible side effects as the child grows to be an adult. It can also be extremely painful, requiring higher dosages of pain medication. Now, smaller instruments have been developed to allow surgeons to make even smaller incisions. They are able to perform a much larger number of surgeries, even on little babies. More centers are starting to use laparoscopy for the neonates as well.
(Source: Dr. Saundra Kay)

FOR MORE INFORMATION ON THIS REPORT, PLEASE CONTACT:

Mari Abrams, PR
720-754-4287
Mari.Abrams@healthonecares.com

If this story or any other Ivanhoe story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Marjorie Bekaert Thomas at mthomas@ivanhoe.com

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