This disease is quite rare: approximately once in two to four thousand cases. From newborn it is considered especially dangerous. If not in time to do the surgery, the child will not survive. And as Chelyabinsk newborn was so serious that not even allowed to move her from ICU to the operating room. Preparation time of the operation was limited. In recognition of those who conducted the operation surgeons Paul Baboshko and Victor Bazaliya, study similar cases in medical practice at the time was once. Just weighed all the risks, possible complications and decided on an emergency operation straight into intensive care.
– With each child weighing 500-600 grams we have multidisciplinary brigade – said the chief doctor of CDCB, chief pediatrician of the region Galina Kireeva. Not only surgeons but also the whole staff of anesthesiologists, intensive care specialists, neonatologists and other specialists. Without them, the nursing child with critically low body weight is impossible. And in this case it was about microscopic surgery, from the category of “flea Shoe”.
the Operation lasted over one and a half hours. Anesthesiologists have developed several options for anesthesia depending on the condition of the little patient during surgical intervention.
Because all children, even those tiny, feel pain. Therefore, is a multicomponent anesthesia – seditious, analgetic and apparatus for muscle relaxation, so that the pulses of the muscles does not interfere with the surgeon’s work. And, as said head of the Department of anesthesiology and intensive care, main child resuscitator of the Ministry of health of the region Elena Gritskova, during the operation it is necessary to additionally warm the little patient, as through the open abdominal cavity there is a big loss of heat. And these babies lowering the temperature, even of half a degree can lead to negative consequences. Because drugs are administered heating devices. And the temperature in the operating room should not be below 37 degrees. Conduct microscopic surgery in these conditions Oh how difficult.
– This little patient is all that difficult to do. All manipulations only with pincers. Hands and nothing can happen to touch said surgeon Paul Babochka. The liver, as a little raspberry – touches her, and she will collapse. I in practice have not even heard about the operations of a diaphragmatic hernia at such a tiny weight. But it was necessary to help the child. It is our thoughts at the time. There was no time to think about something else.
In Russia there is no description of the postoperative period in children with weight and pathology. In Chelyabinsk will appear first. Since surgery it’s been a month and a half. The small patient feels well. Already doubled its weight. Her mother was still suffering from the shock of what happened and very grateful to the doctors.
the Tandem of Paul Baboshko and Victor Bazaliya is well known in the Chelyabinsk region, where they conduct more than 200 surgeries in newborns – half of the total of surgical interventions of ODKB a year.
– This congenital malformations of the gastrointestinal tract, the so-called thoracic surgery. This is a malformation of the Central nervous system ventricular hemorrhage, and this is neurosurgery. Is a surgery a team of surgeons-ophthalmologists retinopathy, a disease that often occurs in preterm babies and may lead to further complete blindness. And retinopathy need to capture at certain time intervals, so that the retina is not completely detached. To to cauterize it and the eyeball can develop normally. We have a team of pediatric urology. Essentially all congenital malformations of the urinary system – including their correction is carried out by them. All of these operations in the region makes our clinic – said Galina Kireeva. – It is a very expensive technology. The care of such children is worth millions of rubles spent on that they could keep body temperature, to breathe and eat on their own.
In Russia are considered viable children born in the period of at least 22 weeks, weighing at least 500 grams and having a height of 25 cm. In most other countries newborns on up to 25 weeks resuscitation assistance.
