Prenatal Surgical Counseling

Beyond Fetal Surgery

Many congenital abnormalities which require surgical correction are now routinely diagnosed before birth, using advanced imaging (ultrasound, MRI) techniques. Surgeons have tried to correct some of these problems prenatally, operating on the child while still in the womb. However, these techniques remain extremely risky to both mother and child. Worse, it is difficult to show clear benefit with most of these procedures, some even showing worse outcomes. The techniques remain highly experimental.

The pediatric surgeons at RMPS have taken a different tact. Using many of the minimally invasive techniques and instruments developed by the practice, many of these complicated procedures can be performed on the first or second day of life. For example, the first-ever thoracoscopic repair of tracheo-esophageal fistula, thoracoscopic lung lobectomy, and laparoscopic repair of intestinal atresia were performed by our practice in Denver. Today, Rocky Mountain Pediatric Surgery offers neonatal minimally invasive repairs of

•Congenital lung lesions (such as Cystic Adenomatoid Malformation, etc)
•Diaphragmatic Hernia
•Duodenal atresia
•Esophageal Atresia/Tracheoesophageal Fistula (TEF)
•Hirschprung’s Disease
•Imperforate Anus
•Intestinal Atresias
•Malrotation
•Ovarian masses
•Sacrococcygeal Teratoma
•and others (downloadable information on these and other diagnoses coming soon)

RMPS woks closely with Dr. Rich Porreco’s high risk perinatal group and the neonatal intensivists at Presbyterian/St. Luke’s Mother and Child Hospital to offer a comprehensive consulting and management program for infants and mothers. When congenital defects are identified, fetal and maternal progress is carefully monitored by the perinatologist to monitor the progress of the disease, and to intervene prenatally if necessary. Meanwhile, the parents are referred to the surgeons for prenatal consultation. Here, parents will learn about the problem, how it is repaired, and other problems the baby may have related to the defect.
Mothers are brought to P/SL for a planned delivery. At P/SL, the delivery rooms are across the hall from the neonatal ICU, so there are no risky transfers to remote facilities for the baby. As the mother recovers, the infant is evaluated and stabilized. Then the baby is operated on using minimally invasive techniques during the first or second day of life. Because minimally invasive surgery leaves much smaller incisions than conventional surgery, the infants recovery much more quickly.

This integrated approach with close coordination among neonatologists, perinatologists, and pediatric surgeons gives the best possible clinical outcomes, limits stress on both parent and baby, and minimizes separation between mother and newborn. This is a significant improvement compared to other programs in which mother and child are treated in separate hospitals, surgery is delayed until the child is larger, and standard open techniques are used which produce greater pain and longer hospital stays for the child.

If you have a high-risk pregnancy and have questions or need help, call us at 303.839.6001.

Disclaimer: Your child's condition is unique. The information contained on this website is not intended to substitute for advice from a doctor or nurse. If you are unsure about any aspect of your patient's care, please contact us at 303-839-6001, or talk to your pediatrician.