Fetal Surgery Baby's Tumor Removed in Womb: Remembering 38 Years Ago Our Attempts of In Utero Surgery for Cleft Lip Repair
This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.
I just saw this article on Miami Baby's Peach-Size Tumor Removed in Womb
It then lead to Fetal Surgery Helps Babies With Spina Bifida
from Feb. 9, 2011.
Both stories brought me back to my time working with Desmond Kernahan, M.D.
the world's first full time Pediatric Plastic Surgeon, and one of my mentors who influenced who I became. He tasked me in our lab to teach myself microsurgery and in utero fetal surgery. This was back in 1974, 38 years ago while I was a medical student at Northwestern University. His concept was simple. Healing in the uterus was special. If we could repair a cleft lip and or cleft palate before birth, there would be little to no scar, the muscle function would not be an issue. It was a principle of prevention making the task of surgery later not necessary. I wonder if Dr. Kernahan factored into my passion about prevention throughout my career such as Dog Bite Prevention
or how to not need a Plastic Surgeon in the Emergency Room. The project fueled my interest in my Microsurgery, magnification, and pediatric surgery. You can see some of my Young Plastic Surgery Patient's Drawings
Our model was the rat, but I was never able to overcome the hydrostatic pressure of the womb and the animal's tiny size. Getting an endoscope into a human size uterus is a much more reasonable size mechanically. In 1990 he was one of the authors on this Intrauterine repair of cleft lip: what's involved.
Since then others have overcome these issues in rats, mice, rabbits, and lambs. I wonder when it will happen on a human or if it already has. Cutting a teratoma mass free could be as involved as the cleft lip repair or more difficult. The details were not there from the report.
Seeing what we were dreaming about and spending so many hours attempting come to fruition. I wonder what Dr. Kernahan would have been thinking of seeing these patients today. For me, it brought back fond memories and pleasant thoughts. I would love to see the Standardized Photographs of Mouth and Lip Movement applied to document a Cleft Lip sculpture, just to see the beauty of movement to prove the theoretical advantages.
Hope this helps,
Michael Bermant, MDLearn More About Plastic Surgery