Dr. Manny's Notes: 'Miracles' of Modern Medicine

Recently, two very interesting cases making headlines have brought to light some of the greatest advances in modern medicine. These stories, touted as 'Medical Miracles' remind us why we as doctors keep searching for answers and of the gift that makes it all worth while; the gift of life.

There are many conditions that can arise during the course of pregnancy that may cause concern. At one time, we would have to wait until the baby was born in order to try to save the baby or to save the limb. But now, more and more research is being done and more interest is being taken in an effort to fix these issues in-utero.

In the first case, Australian surgeons are being credited for saving the leg of an unborn child by operating on her while the mother was just 22 weeks pregnant.

This baby had a condition called amniotic band syndrome. This is a condition where the limbs, hands or feet of a fetus become entangled in bands of tissue, cutting off blood flow. And in this particular case, both legs were in danger of being naturally amputated in the womb. Luckily, surgeons were able to use a very thin, telescopic instrument to zap away at those adhesions with a laser and free the limbs of baby Leah.

This shows you how far we have come in using minimally invasive procedures to deal with a problem that in the past would have meant major complications for this child.

The other case is even more interesting because it's more aggressive. At a hospital in Texas, Little Macie McCartney was welcomed into the world not once - but twice.

Macie had a benign tumor of the lower spine, probably something that we call a teratoma; a soft tissue tumor that's benign, but very vascular. When these tumors grow in a small child, they begin to take away the blood supply from the fetus, which often results in congestive heart failure. Remarkably, surgeons were actually able to partially remove Macie from her mother's womb to perform the surgery that saved her life. When they were done, they put her back in her mother's womb to grow for another 10 weeks, with no further complications.

However, field of prenatal surgery is still in its infancy stage. For years we've been trying to tackle these issues, but we have encountered many problems. One of the major risks when performing surgery on a fetus is premature delivery. Sometimes, when doctors attempt to do an operation while the baby is still in the womb, they ultimately end up doing more damage because the baby is born prematurely or they lose the pregnancy completely.

These kinds of life-threatening complications make our access to research and outcomes in this area of surgery quite limited. In order to get to the baby, you have to go through the mother, so there are 2 lives at risk here, and ethical implications often come into play. Other limitations are evident in the instruments available for the types of procedures necessary to repair the damage caused by a congenital anomaly.

But none-the-less, the field continues to grow. In fact, there are many facilities around the country that are currently doing these procedures under very strict protocol and criteria.

So these are the kinds of surgical miracles that are shaping the face of reproductive medicine. But again there are still going to be limitations. Not every malformation can be repaired in-utero. We as doctors must make decisions by closely examining both the physical health of the mother and the benefits of performing prenatal surgery when a life-or possibly 2 lives-hang in the balance.