Doctors at the Lagos University Teaching Hospital, LUTH, have successfully performed a Thoracoscopic Primary Repair of Oesophageal Atresia with tracheosophageal Fistula on a 13-day old baby.
The Chief Medical Director at LUTH, Prof Wasiu Adeyemo said the surgery through the oesophagus of the neonate entailed minimal access surgery on the baby, the first of its kind in any public tertiary hospital in Nigeria.
“Babies with such conditions are unable to feed, they choke when fed because the tube that carries food to the stomach is blocked. So, they regurgitate, the breast milk comes from their nose and their mouth; they can take it into their chest and it now becomes a problem to them. So that’s first thing and you see them bringing out saliva and it is foaming. Once you see those symptoms, most likely that child has a blockage.
“This surgery would usually have been done as open thoracotomy with ligation of fistula and end-to-end anastomosis of oesophagus. This will leave the neonate with a large chest wound and turbulent post-operative recovery period. But recent advances in the developed nations utilize minimal access surgery (Thoracoscopic repair) which has the advantage of minimal tissue injury and therefore reduced metabolic response to trauma and ultimately reduced surgery associated morbidity and better outcome. The baby recovery after surgery was uneventful. The baby will be discharged from the hospital tomorrow,” he explained.
LUTH is one of the two public hospitals in Nigeria with solely dedicated paediatric laparoscopic towers and laparoscopic instruments. This is made possible due to increase in funding by the Federal Government.
“The management of LUTH expresses our appreciation to the team of surgeons, anaesthetists, nurse and other supporting staff that made this feat possible. Our appreciation also goes to Dr Igwe of EverCare Specialist Hospital for his readiness to share his knowledge and expertise with us in this particular case. LUTH is poised to continue to partner with all Nigerians (home and abroad) with expertise in all specialties of medicine for the benefits of all Nigerians,” said Prof Adeyemo.
Lead surgeon, Dr. Felix Alakaloko said babies who require this kind of surgery cannot eat because their oesophagus, which is the pipe that carries food to the stomach, is blocked at birth.
“Something must be done to reconnect that blocked tube so that they can eat. And now that is where we come in and they come to us and we have to operate them. Now operating them is very difficult. Because you remember this tube that carries food is in the chest, that means you are going to work on the chest of a new born child to go and reconnect the tube.
“The space is very small. So, when you have to cut open, you endanger the patient as well as trying to help the patient because we are going to make the patient go through a lot of trauma. Sometimes the patient cannot be helped immediately, so you have to divert the pipe and then find a way to feed them using tubes which is very, very demanding.
“But with the increased funding for the teaching hospital, we have the equipment and facilities that are cutting edge which are the same as obtained in the international community in America and Canada and even in the UK. The equipment and the human resources are available. And we are able to treat this patient under minimal access. They don’t have so much trauma on them,” said Dr Alakaloko, a paediatric surgeon.
The specialised surgery which costs about N10 million abroad and N6 million at private hospitals, was highly subsidised by LUTH. Management said this particular case cost just N300,000.
“We are not oblivious of the fact many patients, or parents are indigents and poor. We thank the Federal Ministry of Health and Social Welfare and the two ministers for their passion in ensuring increased funding for tertiary health institutions,” said Prof Adeyemo.
By Chimezie Godfrey
