Forty years ago I made my arrival at a small hospital in the Midwest. I was a bit of a surprise to my parents, and not just because I came a few weeks early and weighed only three pounds.
I was born with a congenital defect called a trachea-esophageal fistula. When a baby develops normally, the esophagus, which takes food from the throat to the stomach, and the trachea are separate. In about one in 4,000 births, the two have a connection.
It required doctors to open up my chest and fix a condition that would have otherwise let saliva and contents intended for my stomach to get into my lungs.
I still wear the scar today as a sign of a blessing and medical advancement. It reaches from near the middle of my chest to about the middle of my back, forming a U across the right side of my torso. Though I’ve been pretty healthy since then (they repeated the surgery when I was 2), I have a bout now and then with bronchitis and the muscles on the side of my chest sometimes twitch and spasm.
Fast-forward to present day, and I’m on the phone with Janette Alcantar, 25, of Chandler. Her son, Julian White, was born Jan. 26 with the same condition.
Little Julian doesn’t have the scar I do. He won’t have the muscle spasms I do.
Dr. Ravindra K. Vegunta, chief of division of pediatric surgery for Banner Pediatric Specialists, was able to perform the surgery on Julian that left a barely noticeable, tiny mark on his chest, under his nipple, and another on his back.
Vegunta said Julian was only the second child at Mesa’s Cardon Children’s Medical Center to have the surgery performed this way. He’s not sure anyone else in Arizona is doing the correction with such little evidence of it.
“Even if they are, it’s still pretty rare. Only a small number of surgeons in the world are doing this,” he said.
Since he began practicing as a surgeon 13 years ago, Vegunta’s been using laparoscopy, or minimally invasive surgery, where possible. Though laparoscopy started with adults years ago, that type of surgery is now being used across the country in performing any number of surgeries on children, including appendectomies at Cardon Children’s.
But the trachea-esophageal fistula repair done on Julian — a five-hour endeavor — is the most complicated of the laparoscopy surgeries he does, Vegunta said. In his near decade and a half of practice, he’s only performed it four times. It requires a tiny camera to be inserted into the body in one incision, with medical instruments — rather than a doctor’s hand — inserted into another.
Julian’s mom, Janette, is grateful for the difference. She didn’t even know the surgery was being performed in a different way until after it was done.
The advantage for Julian is not just the lack of scar tissue, Vegunta said. When the surgery is typically performed, doctors must cut through two major muscles on the side of the chest in order to reach the trouble spot. That may hinder the strength of the child’s right side later in life.
Julian is showing his resilience and strength, mom Julian said. He’s already gained nearly five pounds since his birth. And though he’s battling a respiratory infection now – which sounds worse because children who have trachea-esophageal fistula may have a softness of the trachea that leads to noisy breathing – he’s doing well.
“It’s very, very scary obviously,” Janette said. “It wasn’t something we knew ahead of time. It’s something we had to deal with day by day, not knowing how he was going to do. We didn’t know how anything would go.
“It’s been a waiting game from the moment he got out of the surgery until he got out of the hospital. We didn’t know what to expect being first time parents with something like this. We just have to watch him. We’re very cautious with watching him drink his milk properly and illnesses.”
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