Surgeon Uses Innovative Technique to Repair Premature Infant's GI Tract

Procedure First of Its Kind in Georgia, One of 26 Globally

Mariha Spencer of Warner Robins, Ga. was approximately six months pregnant with her first child, Amillia, when she learned her daughter had a rare congenital defect, known as esophageal atresia, which is characterized by an improper or absent connection between the esophagus and stomach that makes feeding impossible. The abnormality makes it impossible for the affected child to eat, and often requires a series of corrective surgeries to be performed soon after the birth of the child.

Trusting Amillia's care to the physicians and staff at Atrium Health Navicent Beverly Knight Olson Children's Hospital (BKO), Spencer had no idea her daughter would become one of just 26 infants globally, and the first in Georgia, to undergo an innovative new procedure designed to repair the abnormality.

"With esophageal atresia, the esophagus doesn't develop or connect to the stomach correctly. The baby ends up having an upper pouch that connects to the mouth, and a lower pouch that connects to the stomach and possibly the airway, with nothing in between. This makes it impossible for the baby to eat. Amillia's case was especially rare, because there was a connection from the upper pouch to her airway, so if she ate, food would go straight into her lungs," said Josh Glenn, MD, pediatric surgeon with BKO.

According to the Centers for Disease Control and Prevention (CDC), esophageal atresia affects approximately 1 in 4,100 infants in the U.S. Baby Amillia's rare form of this rare condition required quick intervention and innovation.

"The distance between the two pouches was too great to pull the two ends together. Normally, we would take a piece of the large intestine to connect the two. This method comes with a lot of complications and risk," said Dr. Glenn. "Amillia was a very complicated case because of the added challenge of separating the esophagus and airway, so we chose to try a recently developed, minimally invasive procedure that we thought would work well for her."

The new approach, which uses magnets to close the gap between the two pouches for the treatment of esophageal atresia, received a Humanitarian Use Device (HUD) designation from the Food and Drug Administration (FDA) in 2018 and was reviewed through the Humanitarian Device Exemption (HDE) pathway. Dr. Glenn and his team worked with Atrium Health Navicent's Institutional Review Board (IRB) to gain access through a humanitarian exemption and received permission to perform this rare procedure at BKO.

With a feeding tube already in place in her stomach from a previous procedure, the repair of Amillia's esophagus required separate, staged procedures. First, Dr. Glenn and his team separated the upper pouch of Amillia's esophagus from her trachea. Once the incision healed, Dr. Glenn and his team then used the Flourish Esophageal Atresia Device from Cook Medical to place two special magnets in the upper and lower pouches of her esophagus.

The magnets pulled together inside Amillia's tiny body closed a gap of approximately four centimeters, connecting the two ends of her esophagus to make it whole. Once both ends of the esophagus were connected, the magnets were removed.

"We were all for it, and we were excited that it was not very invasive. They inserted the magnets, and after two weeks, they pulled them out. Everything grew back together. It was an amazing feeling, and we were so grateful that we could stay in Macon, right here so close to home," said Mariha Spencer, baby Amillia's mother.

In an interview with Macon CBS affiliate WMAZ-TV, Amillia's father Austin Spencer said, "It's so simple. It's truly awesome, just using magnets."

Now, at six months of age, Amillia is doing well and has been discharged from BKO's Neonatal Intensive Care Unit. She is home with her family learning how to eat on her own, and she continues to visit BKO on an outpatient basis as teams work to strengthen and shape her esophagus.

"The surgical team at Atrium Health Navicent Beverly Knight Olson Children's Hospital is on the forefront of innovative care, providing the highest level of treatment for families. We applaud Dr. Glenn and our surgical team for their quick thinking, and for the extra steps to receive a humanitarian exemption from the FDA, to provide this infant the right care, at the right time, and in the right place - close to home," said Tom Oliver, MD, Chief Clinical Officer for Atrium Health Navicent.

Serving Georgia families since 1987, BKO opened a new state-of-the-art facility in Macon on February 25, 2019. The new hospital includes four pediatric operating rooms, designed specifically for patients with smaller bodies, and a 66-bed Level III NNICU that provides care for families from across the state. For more information on BKO, please visit www.childrenshospitalmacon.org.

About Atrium Health Navicent

Atrium Health Navicent, the leading provider of healthcare in central and south Georgia, is committed to its mission of elevating health and wellbeing through compassionate care. Providing more than 1,000 beds and offering care in 53 specialties at more than 50 facilities throughout the region, Atrium Health Navicent provides care for healthcare consumers' through an academic medical center; community, pediatric and rehabilitation hospitals; urgent care centers; physician practices; diagnostic centers; home health; hospice and palliative care; and a life plan community. Atrium Health Navicent is dedicated enhancing health and wellness for individuals throughout the region through nationally-recognized quality care, community health initiatives and collaborative partnerships. For more information, please visit www.navicenthealth.org.

About Cook Medical

Since 1963, Cook Medical has worked closely with physicians to develop technologies that eliminate the need for open surgery. Today we are combining medical devices, biologic materials and cellular therapies to help the world's healthcare systems deliver better outcomes more efficiently. We have always remained family owned so that we have the freedom to focus on what we care about: our patients, our employees, and our communities. Find out more at cookmedical.com, and for the latest news, follow us on Twitter, Facebook and LinkedIn.