The Fetal Surgery Project


One of the goals that we pursue most passionately, as an Organization, is that of supporting the growth of professionals who operate in fields as complex as that of neonatal surgery.

It is for this reason that the various collaborative efforts that we have coordinated with a prestigious facility like the Mangiangalli Clinic of Milan’s Policlinic Hospital are a source of pride for us. Over the past few years, this facility has become one of Italy’s best with regards to neonatal surgery. This status is perhaps most clearly exemplified by the large number of cases that have been undertaken by the Mangiagalli Clinic in 2015, 130. No other hospital in Italy has treated a higher number of cases over the same time span.

Discussions with representatives and professionals from the clinic about possible future collaborations raised the theme of fetal surgery. This field is concerned with operations that are performed directly in utero, on fetuses affected by serious congenital malformations. The techniques developed in this field offer a larger upside to the little patients as opposed to operations performed on newborns a few days after birth. The Mangiagalli Clinic is Italy’s only facility offering this kind of care, and it has been doing so for over 5 years. This discipline, however, is still in its relatively early stages, and as such, it is continually developing and evolving. In order to be able to offer the most complete and up-to-date care, then, it is necessary to participate to various training and refresher courses. Given that supporting professional training has long been one of our main objectives, we immediately offered our support to the Mangiagalli Clinic in their efforts to have their personnel participate in courses of this sort. This eventually spawned our “Fetal Surgery” project.

This project, at least initially, will be divided in two separate sections. One section will deal with adding a serious malformation to the kinds of conditions on which the Mangiagalli clinic’s surgeons can perform fetal surgeries. The malformation in question is the myelomeningocele. This is a rare condition, which consists of a serious spine defect, and which can be gravely invalidating for newborns and children suffering from it. Acquiring the necessary techniques in order to offer the proper care for this condition would position the Mangiagalli clinic as one of only four centres in Europe to be able to do so. In order for that to come to fruition, professionals from several disciplines (neonatal surgery, pediatric anesthesia, obstetrics and neurosurgery) will have to participate in training programs organized at the few international facilities that already offer this kind of care.

The second section of this project deals with the creation of a “Fetal Center” in both the Groot Schur Hospital and the Red Cross Children’s Hospital of Cape Town, South Africa. This fetal surgery center would be the first to be realized in South Africa and the only one in Sub-Saharan Africa. The main objective of this section of the project is to offer, to professionals working in these two hospitals, the opportunity of following training courses in the Mangiagalli clinic. These courses would cover several disciplines, including obstetrics, anesthesia, neonatology and pediatric surgery. They would have the main objective of providing South-African doctors with the basic techniques and skills needed for opening and operating a fetal center. Professionals from the Mangiagalli clinic will provide support and consulting throughout the process, even after the courses will have taken place.

A figure which really highlights the importance of this part of the project, in our opinion, is the percentage of pregnant women in the Cape Town area who have access to prenatal diagnosis. Currently, said figure stands at less than 20%, which is appallingly low. It is our belief that, through both the aforementioned courses and an effort to sensitize the local authorities, this figure can be vastly improved. This is why we chose to tackle this challenge as part of our efforts within the field of fetal surgery.

Furthermore, given the increasing relevance that the field of fetal surgery is gaining in the scientific world, we felt that it would be appropriate to add another initiative within this project: supporting the organization of the "X International "Spring Workshop" Policlinico: innovations in Fetal Therapy", which took place in May 2018 within Milan's Policlinic Hospital. This event was in many ways unique, seen as it brought together for the first time some of the world's leading experts in a variety of fields: fetal care and therapy, neonatology, as well as pediatric surgery. Overall, more than 300 professionals from these fields and more took part in this event, making it one of the most successful and stimulating events of its kind.

The multi-faceted nature of these endeavours is what immediately drew our attention to them. Having, in a single project, the possibility of providing international support while also being able to focus on the local territory is a source of great interest and motivation. Our main goal is to offer, to as many patients as possible, the best possible care as defined by the most recent developments in technology and research. This pushes us to always find new ways of supporting the activities of extraordinary professionals like those operating in the Mangiagalli clinic, as well as those who work in a world-renowned structure like the Red Cross Children’s Hospital. To help us reach this goal, please visit the “What You Can Do" section of our website. In order to make a donation specifically for this project, please specify “Fetal Surgery” as a project when prompted.  


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Associazione Amici della Chirurgia Pediatrica Odv

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