Thursday, July 24th, 2014
New methods of performing surgeries while babies are still inside their mothers’ wombs are becoming more common, in many cases greatly improving the quality of life of babies who are diagnosed with potentially serious conditions affecting the heart, bladder, larynx, and more. One medical group in Mexico has successfully performed 200 such surgeries, and its doctors note that the new technologies and technique for what’s called “fetal medicine” are improving and becoming more widely available, parents need to be better educated about their medical options, especially if they are experiencing a high-risk pregnancy. More from ScienceDaily:
Although Mexico Fetal Medicine Group, located in Queretaro, has established itself as a cross reference for prenatal health in the country, Méndez González recognizes that there is a lack of prenatal drug culture among Mexican parents. “Generally the pregnancy situation is consulted to gynecologists, who are not necessarily specialists in fetal medicine. Lacking experience in this discipline, sometimes the detection of health problems is too late for the baby,” said the specialist at Fetal Medicine Mexico.
In the words of the medical specialist, consolidating a cross reference in fetal medicine in the country has positive effects such as the accumulation of knowledge and experience to practice and investigate medicine in unborn babies. Méndez González noted that the emergence of ultrasound changed the way people see pregnancy as the unborn baby began to be considered as a patient in need of its own care.
Last month, a new technology was announced that can perform in-utero surgeries, using a tiny robotic arm, on babies who are diagnosed with spina bifida, a condition which affects 1 in 2,500 babies worldwide.
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Thursday, June 19th, 2014
Some birth defects, including spina bifida, may soon become correctable conditions, if a new robotic technology that can perform surgery on a growing fetus comes to fruition. The technology, which is a tiny robotic arm, is currently under development by British researchers, as CNN reports:
Spina bifida is one such disease, affecting approximately 1 in 2,500 newborns worldwide, where a lesion on the back leaves the spinal cord exposed in the womb, leading to severe disabilities, learning difficulties, and sometimes death.
The best option is to perform surgery to correct the problem before the baby is born but the complexities of such a procedure mean this currently only takes place in five countries worldwide. Most countries instead perform surgery after a child is born, but when the majority of damage has been done.
To reduce the risk involved in fetal surgery, scientists at University College London (UCL), and KU Leuven in Belgium are developing a miniscule robotic arm to enter the womb with minimum disruption to mother and baby. The robotics are targeting spina bifida but also lesser known conditions such as twin-twin transfusion syndrome, where blood passes unequally between twins who share a placenta, and fetal lower urinary tract obstruction, where babies are unable to urinate in the womb and their bladders become large and distended.
Surgery on fetuses has been effective in treating some conditions to date, but for spina bifida, the risks to mother and baby mean surgery is currently only performed in a handful of countries, where specialist teams exist.
“Most birth defects can be prevented if we can intervene earlier,” says Professor Sebastien Ourselin, from the UCL Center for Medical Image Computing, who is leading the new research project. “But currently, surgical delivery systems are not available and operating on babies in the womb is reserved for just a handful of the most severe defects as risks are too high.”
Image: Fetus, via Shutterstock
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Wednesday, June 18th, 2014
Last year, the American Academy of Otolaryngology—Head and Neck Surgery Foundation issued new guidelines that called for “watchful waiting” to take the place of rapid progress to ear tube surgery for kids who have frequent ear infections. Now, a review of the procedure’s frequency across the U.S. shows that it is in fact reducing the number of ear tubes, which are surgically inserted while a child is under anesthesia, but perhaps not at the rate the foundation had hoped. More from the Wall Street Journal:
While it’s too early to tell, “anecdotally it does seem to have made a difference,” said Richard Rosenfeld, chairman of otolaryngology at SUNY Downstate Medical Center in Brooklyn, N.Y. He chaired the task force that drew up the guidelines.
The guidelines state that for children with recurrent ear infections, ear tubes, or tympanostomy tubes, should be put in place only if middle-ear fluid is also present in at least one ear at the time of inspection. Children with persistent fluid buildup in the middle ear of both ears for at least three months, with or without an ear infection, are also candidates for ear-tube surgery.
Previously many doctors recommended ear tubes in children who either had recurrent ear infections—three in six months or four in a year—without fluid, or middle-ear effusion. Ear infections are concerning because of potential hearing loss that could cause developmental delays.
Contributing to a desire by doctors and parents to avoid surgery are concerns about the use of general anesthesia in young children. Researchers and doctors are exploring devices that would enable ear-tube procedures to be performed using alternatives. Preceptis Medical, a Plymouth, Minn., company, is testing a device, the Hummingbird, that uses nitrous oxide instead of general anesthesia in clinical trials at four sites, including the Mayo Clinic. Acclarent, a division of Johnson & Johnson, is working on using technologies that may allow for ear-tube procedures to be done in-office without general anesthesia, a spokeswoman said.
To insert tubes, doctors make a small cut in the eardrum and place the tiny, cylinder-like tube through it. It takes less than 10 minutes. The tube helps with air flow and prevents the buildup of fluids behind the eardrum. The tubes usually fall out within a year or two, and the holes close on their own, though sometimes a doctor must close them surgically. Children with tubes can still get ear infections, but doctors say they are generally less frequent, milder and can be treated with antibiotic drops.
Image: Ear exam, via Shutterstock
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Wednesday, April 23rd, 2014
Children who suffer from appendicitis may not be facing inevitable surgery, if a new study touting the safety and effectiveness of an antibiotic treatment becomes mainstream practice. More from Reuters:
Forgoing surgery to remove the appendix may not be an option for all kids, researchers say, but just three of 30 children who tried the antibiotics-only route ended up needing surgery.
“In this group of patients with uncomplicated appendicitis – in the people we studied, non-operative management with antibiotics alone appears to be a reasonable alternative,” Dr. Peter Minneci told Reuters Health.
He is the study’s lead author, from Nationwide Children’s Hospital in Columbus, Ohio.
Appendicitis is when the appendix, a small tube-shaped extension of the colon, becomes inflamed and filled with puss. The appendix may burst without treatment and cause a widespread infection.
Although the cause of appendicitis is not known, Minneci said it may often occur when a piece of feces blocks the appendix and allows bacteria to proliferate. Other inflamed tissues may also block the appendix and cause the condition.
“It used to be that people would operate on appendixes in the middle of the night,” he said. “Then we found that it was safe to give them antibiotics and operate on them in the morning.”
Doctors began noticing that some of the children were feeling better in the morning after the initial treatment of antibiotics.
“They were hungry and they didn’t have pain anymore,” Minneci said.
To see whether antibiotics alone might be enough to treat appendicitis, he and his colleagues enrolled 77 children and teens brought to the emergency room at Nationwide Children’s Hospital from October 2012 to October 2013.
All the participants had been diagnosed with uncomplicated acute appendicitis. Their appendixes had not burst, were not overly swollen and imaging did not show a hard piece of stool blocking the organ.
Those uncomplicated cases represent about one in five appendicitis cases at the hospital, the researchers note in the Journal of the American College of Surgeons.
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Image: Child in hospital, via Shutterstock
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Friday, April 18th, 2014
The FDA is warning that a procedure in which an electronically powered device is used to grind up and remove uterine growths, saying that the procedure carries a risk of inadvertently spreading an undetected cancer to other parts of the body. More from The Associated Press:
Known as laparoscopic power morcellation, the technique is used to treat painful fibroids, either by removing the growths themselves or the entire uterus.
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The procedure was developed as a less invasive alternative to traditional surgery.
But FDA says the procedure could actually be spreading uterine cancer to other parts of the body. The agency estimates that 1 in 350 women who undergo fibroid procedure may have an undetected cancer known as uterine sarcoma.