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Winter 2012

Better Odds for Babies

A brighter outlook for infants with congenital diaphragmatic hernia.

Date: February 1, 2012

Once in about every 3,000 live births, babies are born with all of their intestines up in their chests. Until recently, the condition often meant that the newborn would not survive. But things are changing, says pediatric surgeon Jeffrey Lukish, who is among a group of Hopkins experts who are improving outcomes for infants with congenital diaphragmatic hernia.

With their protruding bowel compressing their lungs and heart, babies typically present with respiratory distress that requires rapid transfer to the care of NICU specialists. Virtually all will need surgery to reverse the herniation, and Lukish says this is where the prognosis is changing most.

Lukish and his surgical colleagues are able to restore the protruding bowel back below the diaphragm using just three 3-centimeter keyhole incisions. Their minimally invasive method eliminates the need to make the more traumatizing open incision into the chest cavity required in the standard procedure and helps speed recovery after the operation.

Lukish and his group have also adapted a new suturing technology— developed for adult operations—that seems to extend nicely to pediatric cases. They are using sutures lined with fine barbs that negate the need to tie off the line with each stitch, which speeds closing and gives the newborn patients yet another edge for survival.

Lukish and his group have already performed these hernia repairs six times during the past year, all successfully.