February 17, 2011

VUMC offering fetal surgery for spina bifida

VUMC offering fetal surgery for spina bifida

With the conclusion of a National Institutes of Health-funded study showing clear benefits for babies who undergo fetal surgery to treat spina bifida, Vanderbilt University Medical Center's surgical team is immediately offering the procedure to patients.

Officials in the new Fetal Surgery for Spina Bifida Program have scheduled a number of consultations for those interested in the high-profile surgery, a delicate procedure to repair a baby's spine while still in the mother's womb.

Vanderbilt surgeons pioneered the procedure in 1997, and have performed more than 200 fetal repair surgeries.

Results from the seven-year trial, Management of Myelomeningocele Study (MOMS), show that babies who receive in utero repair of myelomeningocele, a severe form of spina bifida, have an increased chance of walking and are less likely to suffer from hydrocephalus (build-up of fluid on the brain that requires a shunt).

Vanderbilt operated as a trial site in the MOMS study, and performed 177 repairs prior to the study, including the first-ever procedure of its kind done in the world.

John Brock III, M.D., surgeon-in-chief for the Monroe Carell Jr. Children's Hospital at Vanderbilt and principal investigator for the Vanderbilt site of MOMS, says Vanderbilt's experience and multi-service commitment makes it one of only a few centers prepared to begin this intervention immediately.

“I think the critical factor in offering this surgery is the fact that we have a team in place that understands the process from beginning to end,” he says.

“It's a multi-specialty effort, and our emphasis is taking care of the whole family, from the first consultation and the explanation of the risks and benefits, to the surgery and the post-surgical care for both the mother and the infant after birth,” Brock said.

Results from the MOMS Study mirror a 1999 article authored by Noel Tulipan, M.D., director of Pediatric Neurosurgery, and the Vanderbilt team, which was published in the Journal of the American Medical Association.

Brock says Vanderbilt is fortunate to have the majority of the team in place that has overseen this project from the very beginning, including Tulipan, who has performed more fetal repair of spina bifida surgeries than anyone in the world.

In addition, Brock said Vanderbilt has experienced anesthesiologists and nursing staff, along with the same outstanding neonatal care, pioneered by William Walsh, M.D., professor of Pediatrics and director of Nurseries at Vanderbilt. Kelly Bennett, M.D., the maternal-fetal specialist who performs the maternal portion of the surgery, will lead the Maternal Fetal Medicine program.

The new Fetal Surgery for Spina Bifida Program will be housed in the Junior League Fetal Center at Vanderbilt.

For more information, call (877) 875-3737 or visit the website at www.childrenshospital.vanderbilt.org/fetalsurgery.