UAE: Baby born with wide gap in food pipe treated successfully
Team at Sheikh Shakhbout Medical City in Abu Dhabi perform complex keyhole surgery
Abu Dhabi: A newborn infant born without a complete oesophagus (food pipe) has been successfully treated at Abu Dhabi’s Sheikh Shakhbout Medical City.
The hospital said the infant was born with long-gap oesophageal atresia, a congential disorder where the food pipe or oesophagus does not form properly during pregnancy. This was combined with tracheoesophageal fistula (TEF), an abnormal connection between the oesophagus and the wind pipe or trachea. The combination of conditions meant the infant was unable to feed and breathe at the same time without choking.
Urgent care required
Affecting one in 4,000 babies globally, oesophageal atresia occurs when the upper oesophagus, which transports food from the mouth to the stomach, does not connect with the lower esophagus and stomach.
Repairs must be carried out as soon as possible after birth in order to ensure the patient’s health and development. In this case, the procedure was carried out within a month of birth on a baby who had been delivered prematurely.
Special team
The SSMC’s medical team, which included an anaesthesiologist, a neonatal intensive care team, a paediatric surgeon, a speech and swallowing expert, and a dietitian worked together to treat the patient and restore function, allowing him to feed normally without facing breathing difficulties.
“SSMC is proud to be on the cutting edge of clinical practice and to offer integrated care for even the most complex and rare of conditions. The expertise and harmony our team demonstrated were foundational to having this successful outcome and are a testament to SSMC upholding its promise of putting patient needs first. Through our pillars of practice, research and education that frame our unique model of care, SSMC aims to continuously evolve and set a new standard for the compassionate care it provides,” said Dr Matthew Gettman, chief medical officer at SSMC.
Cutting-edge surgery
“Given that our patient had an especially challenging birth – he was under 28 days old and weighed 1.9kg – our treatment approach had to be extremely intricate. The gap between the two esophageal segments was wide and, usually, a staged repair is performed for these anomalies. We opted for a thoracoscopic single stage procedure instead of making a long surgical incision to the chest wall,” Dr Iftikhar Jan Suleiman, consultant pediatric surgeon and chairman of SSMC’s paediatric surgery division.
“The minimally invasive keyhole surgery was successful in repairing the patient’s [condition], and allowed us to create a new connection to the esophagus. We are proud of the highly coordinated team effort by the neonatal intensive care team and our highly specialised anaesthesiology team, whose expertise with paediatric surgery was essential to the success of this life-saving procedure.”
Complexities
“The patient also suffered from co-morbidities alongside his main condition and his very low weight due to the difficult birth he encountered. Those included an opening between two major blood vessels in the heart, neonatal seizures, hypoglycaemia and electrolyte disturbances, which required a meticulous effort from the anaesthesia team to manage the patient intra-operatively. Additionally, we set a particular focus and plan on adequately ventilating him and preventing hypothermia and hypoglycemia to keep the patient in optimal condition,” said Dr Tamer Hamed Ibrahim, consultant anesthesiologist and pediatric anesthesia lead at SSMC.
“I am so happy that our multidisciplinary team approach with this highly advanced surgical procedure helped save this patient’s life, and I am so grateful to all the team members who played an integral role in making this happen,” Dr Ibrahim said.
The baby recovered swiftly from the procedure, and was discharged a week later.
Sheikh Shakhbout Medical City is one of the UAE’s largest hospitals, and is equipped to handle serious and complex cases. It has been set up under a joint-venture partnership between the Abu Dhabi Health Services Company (Seha) and US-based research-focussed healthcare facility, the Mayo Clinic.