In June, a Cleveland Clinic patient gave birth to a baby girl whose congenital neural tube defect — a myelomeningocele (MMC) lesion — had been surgically repaired prenatally, when the fetus was nearly 23 weeks old. MMC, or open spina bifida, is the most common central nervous system congenital defect, occurring in approximately 1,645 births annually in the United States.

The successful operation and subsequent delivery were a first for Northern Ohio and marked the start of the fetal surgery era at Cleveland Clinic. The multidisciplinary team was led by one of the world’s most experienced fetal surgeons, Darrell Cass, MD.

The 90-second video below provides a recap of the historic procedure. For a more detailed account, read the Consult QD article here  and see an excerpt below. 

“I couldn’t be happier with the surgical outcomes and with the performance of the talented multidisciplinary team,” says Dr. Cass, who joined Cleveland Clinic Digestive Disease & Surgery Institute’s Department of General Surgery as Director of Fetal Surgery in 2017 to build a full-spectrum fetal surgery program. Previously, he co-founded and co-directed Texas Children’s Fetal Center in Houston for 17 years.

Dr. Cass trained with the founding fathers of fetal surgery and completed postdoctoral research fellowships at the University of California, San Francisco (UCSF), and the Children’s Hospital of Philadelphia (CHOP).

Those institutions, along with Texas Children’s, are the first three centers globally to conduct successful open fetal surgery for life-threatening congenital malformations. Dr. Cass has performed more than 160 fetal surgeries since 2002 and intends to elevate Cleveland Clinic’s program to world-class status.

“Every case is challenging, but in a way, spina bifida cases are a tiny bit easier than the cases that are life-threatening,” Dr. Cass says. “In addition to improving the outlook for these two babies, it’s been a good exercise for our team to prepare for more complex fetal surgeries, which we expect will come.”