Good Medicine Saves Baby with Severe Malformation

Teamwork and ‘Good Medicine’ Saves Baby with Severe Malformation

Teamwork at Auckland’s Starship Hospital and advances in paediatric anaesthesia, and neonatal intensive care were crucial to the success of an operation, regarded as the ultimate challenge in reconstructive paediatric surgery.

In a paper entitled, “Cloacal Exstrophy-The Ultimate Challenge” which will be presented at the Royal Australasian College of Surgeons Annual Scientific meeting in Hamilton this week, Paediatric Urologist, Vipul Upadhyay discusses what is thought to be New Zealand’s first successful operation to correct the most severe ano -rectal, genito-urinary, and abdominal wall defect type malformation in a newborn baby.

No one knows why some babies are born with such severe abnormalities.The condition is very rare, occurring in only 1:500,000 births.

Mr Upadhyay says that the ten-hour long operation, performed early this year on a baby born with such an anomaly is complicated and requires a lot of reconstruction.

“The parents were willing to try anything so we went ahead pushing the frontiers of modern surgery and medicine”.

“The anaesthetic care which kept the new born infant unconscious for such a long operation, and the neonatal intensive care are the most important factors for success in such cases. It’s team work and the support I received from my surgical and medical colleagues at Starship was excellent.”

The operative and post operative care involved specialists in intensive care, radiology, paediatrics, urology, genetics and nephrology along with teams of excellent neonatal, operation theatre and ward nurses.

Mr Upadhyay believes this the first time a cloacal exstrophy operation has been performed in New Zealand. He hopes his presentation at this week’s Royal Australasian College of Surgeons Annual Scientific meeting will confirm that and stimulate further discussion among surgical colleagues who may have had a similar professional experience.

Mr Upadhyay, who more commonly performs paediatric bladder reconstruction surgery, was trained in the United Kingdom where cloacal exstrophy cases are slightly more common.

He says that although it is too early for definite predictions about the future health of the baby in question, the prognosis is good.

The Royal Australasian College of Surgeons is an internationally recognized organization representing more than 6,300 members, including 1,700 trainees in nine different specialties in New Zealand and Australia – 90 per cent of surgeons in both countries have been trained and examined by the College. Seven hundred New Zealand surgeons are members of RACS.

The key roles of the college are in advocacy, education, professional development and membership support. The nine specialist areas represented by RACS are: general surgery, neurology, urology, otolaryngology, paediatrics, plastic and reconstructive surgery, vascular surgery and, cardio-thoracic surgery.

The conference – to be held at the Novatel Tainui in Hamilton will run from Tuesday September 13 to Friday September 16. Media are welcome to attend.

ENDS

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