First Successful Fetal Surgery in Latin America

December, 1997

Again Costa Rica leads the way in medical care in Latin America. And, it’s not far behind the U.S. in pursuing innovative and state of the art medical procedures.

On November 10, 1997, doctors at the public hospital Calderon Guardia, operated on the right lung of a seven-month fetus still in the mother’s womb. This intrauterine operation, performed by Dr. Gerardo Escalante López* chief of fetal medicine at the hospital, is a first for Costa Rica and, apparently, all of Latin America. In fact, only fifteen other operations of this nature have been performed worldwide. Both fetus and mother are now doing well and the baby, to be called María Consuelo, is developing normally.

The intrauterine operation was performed to remove a congenital malformation (cyst) which was detected on the right lung of the fetus at five months. If allowed to continue to grow, the cyst would have crowded out vital organs and eventually killed the fetus. The operation entailed significant risk for the fetus. The technique involved piercing the back of the fetus with a catheter 25mm in length and 3mm in diameter. Once the catheter was in place, the liquid in the cyst was drained and a very small valve was inserted to allow continued drainage of excess liquid into the fetal sac where it will be absorbed naturally.

Post-operative monitoring insured that the internal organs of the fetus were returning to their correct positions and that the fetus was again developing normally. Immediately after birth the baby will be transferred to the children’s hospital where the decision will be made by a team of neonatal specialists whether to remove the valve or operate to remove the remaining body of the now deflated cyst. Prognosis for eventual complete recovery and normal development of Maria Consuelo is excellent.

That such a highly complex and advanced operation could be performed in Costa Rica may surprise people living in other “developed” countries. However, those familiar with the excellence of the Costa Rican medical system are not at all surprised; such quality care is routinely expected of the many dedicated and well-trained medical professionals who make up our world-class health care system.

*Dr. Gerardo Escalante López and his wife, Dr. Delia Ribas Valdés, are the co-directors of the Costa Rican Infertility Institute (Instituto Costarricense de Infertilidad). Both are dedicated professionals with training and skills found in the finest international medical institutions.