So the most complicated thing we do right now is open fetal surgery for
spina bifida. So the mom is asleep under a general anesthetic and there are six
surgeons and physicians in the operating room dedicated to caring for the fetus.
The first is a maternal fetal medicine doctor (Dr. Peterson), myself, Dr. Foy is the
neurosurgeon that repairs the spine in the back of the fetus, Dr. Hoffman is a
fetal anesthesiologist that watches every
heartbeat of the fetus and helps us make sure that we are keeping the fetus safe
at all times, there is a pediatric cardiologist in the room as well that
watches every heartbeat and makes sure the cardiac function is normal
throughout the entire operation, and an anesthesiologist for the mother as well.
So it's a very complex team of people. Every step has to be well
orchestrated and we all have to know what everybody else is thinking and
doing at all times. So after we make the incision on the mom, we expose the uterus
and find a good place where the placenta is not near. And we open the uterus
just enough really to expose the fetus' back, and Dr. Foy comes in to do
the repair of the spinal cord, put the fetus back. During that time we're
instilling fluids so that the fetus is essentially floating and the cord isn't
impeded on in
anyway. And Dr. Peterson is watching with ultrasound to make sure we have
appropriate amounts of fluid during the entire case. And then as I'm closing up
the mom's uterus, Dr. Peterson again is checking the fluid levels are making
sure everything is OK, and the cardiologist and anesthesiologist are
checking again to make sure that fetus' heart is stable and is functioning well
during this whole thing. And we put the fetus back, close the mom's uterus and
close the incision in mom. And it takes about two hours. It's a long — it's a complex —
two hours. Every minute is very complex, but it goes very quickly.
