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13 August 2020An exceptional surgery to correct spina bifida in utero at the twenty-sixth week of pregnancy performed at Gemelli. It was created by a team composed of gynecologists, obstetricians and neurosurgeons from the Agostino Gemelli IRCCS University Polyclinic Foundation and from the Catholic University. The child, who was given the name of Tommaso, was born a few days ago and is fine.Tommaso was suffering from a severe form of spina bifida, myelomeningocele, characterized by the lack of closure of the neural tube at the lumbosacral level, with protrusion of the meninges and the spinal cord at this level. Surgical correction is typically done after birth, but these defects worsen over the course of pregnancy. For this, an early correction in utero was chosen.
The baby was operated on in the twenty-sixth week of pregnancy last June 4, with an open surgery technique. After having incised the mother's abdomen, with a modified caesarean section, the uterus was "externalized" on which an 8 cm incision was made, taking great care not to cut near the placenta, so as not to jeopardize the continuation of pregnancy. After opening the amniotic sac, the obstetricians arrived at the baby. And here the neurosurgical phase of the intervention began, lasting 35-40 minutes and entrusted to Professor Gianpiero Tamburrini, head of the Child Neurosurgery Unit of the Agostino Gemelli IRCCS University Hospital Foundation and to Dr. Luca Massimi. "In microscopic vision - comment the Neurosurgeons - we reconstructed the spinal cord which was literally open and malformed. We then reallocated it in the spinal canal and finally reconstructed the meningeal plane and the skin". The obstetric team then stitched up the amniotic sac, the uterine wall and finally the abdominal wall of the mother.