SciTech

WakeMed doctor fuses newborn’s foodpipe without surgery

From left, parents Evan and Suzanne Dapo with their 8-week-old daughter Annalise Dapo and WakeMed pediatric surgeon Dr. J. David Hoover all laugh at the question if the Dapo's daughter had become a “magnet” for attention during a Thursday interview in the pediatric ward at WakeMed Hospital, Raleigh. The laughter was generated because of a medical breakthrough by Dr. Hoover and staff at WakeMed Pediatrics in the repair of Annalise's incompletely formed esophagus between her mouth and stomach by stretching the two ends to meet by use of attracting magnets slowly drawing together, thereby avoiding more serious surgery.
From left, parents Evan and Suzanne Dapo with their 8-week-old daughter Annalise Dapo and WakeMed pediatric surgeon Dr. J. David Hoover all laugh at the question if the Dapo's daughter had become a “magnet” for attention during a Thursday interview in the pediatric ward at WakeMed Hospital, Raleigh. The laughter was generated because of a medical breakthrough by Dr. Hoover and staff at WakeMed Pediatrics in the repair of Annalise's incompletely formed esophagus between her mouth and stomach by stretching the two ends to meet by use of attracting magnets slowly drawing together, thereby avoiding more serious surgery. hlynch@newsobserver.com

They took turns cradling baby Annalise before a firing line of videocams and photographers recording the scene in an intensive care unit at WakeMed Hospital in Raleigh.

As Annalise enthusiastically sucked her formula bottle, mom, dad and doctor fielded questions about the lifesaving procedure performed for the first time in the United States.

The 8-week-old was born at WakeMed with a partially missing esophagus, or foodpipe, which came to a dead end. Lacking about 1.5 inches of esophagus, the newborn survived by means of feedings through a gastric tube inserted through a port in her side.

Less than two weeks ago, WakeMed’s Dr. J. David Hoover, a pediatric surgeon, fused the baby’s two disconnected foodpipe sections, making the repair without surgery.

Hoover pulled it off by inserting magnets into the two blind sections of esophagus and allowing magnetic force to pull both ends together to create a single organ. On Friday, he demonstrated the magnet device, letting the magnetic nubbins vibrate as they drew near and then snapped together.

The magnets used on Annalise were removed Monday, and she took her first sip later that day. By Friday, Annalise imbibed formula like a pro.

“It’s definitely a medical breakthrough,” Hoover said Friday. “And their hospitalization bill is on the magnitude of hundreds of thousands of dollars less.”

Annalise will be going home to Wake Forest on Sunday, at a tender age of 60 days. Had surgery been required, she would have been sedated for weeks and hospitalized several more months.

The pint-sized pioneer is the first to undergo nonsurgical fusion of the esophagus in the United States.

“It was jaw-dropping,” said Annalise’s father, Evan Dapo, a physician assistant. “Having what’s technically not even a surgical option is just amazing.”

Little-known procedure

Only about 1 in 80,000 babies is born with a condition such as Annalise’s. She was able to be treated with magnets because Hoover happened to know about the procedure from a medical article.

“Not a lot of people know about it,” Hoover said. “There’s no sutures, no incisions.”

Hoover contacted the inventor, Dr. Mario Zaritzky, a pediatric radiologist at the University of Chicago’s Comer Children’s Hospital; Zaritzky then traveled to Raleigh to advise WakeMed specialists.

Reached by phone Friday, Zaritzky said most children born with a partially missing esophagus have a foodpipe growing into their windpipe, or trachea. In those cases, surgery is required to disconnect the two wrongly fused pipes, and it makes sense to use surgery to repair the esophagus, too.

In Annalise’s case, though, the foodpipe was not connected to anything else, just missing a section, so it made sense to try magnets without surgery. Even so, doctors had to wait for Annalise to gain at least 2 pounds before the magnet procedure could be performed.

Winston-Salem device

Zaritzky’s device was developed and manufactured in Winston-Salem by Cook Medical. It was approved for humanitarian use in this country just two years ago.

While Annalise is the first to go through the magnet procedure without surgery, three others have been treated in the U.S. with a combination of magnets and surgery. And nine have been treated with the magnet procedure in Argentina, where Zaritzky originally came up with the concept.

In all, the procedure has been used 13 times in the past 14 years, Zartitzky said.

At WakeMed, doctors noted that Annalise’s magnet therapy stretched her foodpipe together within 36 hours. Once the magnets “mated,” her esophagus self-grafted within a week.

“This is like a miracle,” said Dr. Duncan Phillips, WakeMed’s director of pediatric surgery. “I’ve been doing this for 19 years and I have never seen anything like this.”

Murawski: 919-829-8932

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