To Mend a Birth Defect, Surgeons Operate on the Patient Within the Patient

HOUSTON (New York Times) — The patient, still inside his mother’s womb, came into focus on flat screens in a darkened operating room. Fingers, toes, the soles of his feet — all exquisite, all perfectly formed.

But not so his lower back. Smooth skin gave way to an opening that should not have been there, a bare oval exposing a white rim of bone and the nerves of the spinal cord.

“All right, it’s the real deal,” said Dr. Michael A. Belfort, the chairman of obstetrics and gynecology at Baylor College of Medicine and obstetrician and gynecologist-in-chief of Texas Children’s Hospital.

The fetus, 24 weeks and two days old, less than two pounds, was about to have surgery. He had a severe form of spina bifida, in which the backbone and spinal cord do not develop properly. Children born with this condition usually cannot walk, and suffer from fluid buildup in the brain, lack of bladder control and other complications.

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