Quirónsalud performs the first surgery in Malaga's healthcare system on a baby with a severe esophageal malformation.

Esophageal atresia is a congenital malformation in which the esophagus, the tube that carries food from the mouth to the stomach, does not form continuously, but is interrupted or divided into two parts. In many cases, there may also be an abnormal connection between the esophagus and the trachea, allowing milk or saliva to enter the respiratory tract. This prevents the newborn from feeding normally and can cause serious respiratory problems, thus requiring urgent surgical intervention within the first hours or days of life to reconstruct the digestive tract. The Pediatric Surgery Service at Quirónsalud Málaga Hospital has successfully performed a highly complex technical procedure: the thoracoscopic repair of this severely malformed esophagus, which also had a tracheoesophageal fistula, with the newborn being only 24 hours old.

According to Hospital Quirónsalud Málaga, this is the first surgery of its kind in the province, both in the public and private systems, and among the first in Andalusia. "This situation prevents normal feeding and can compromise breathing, thus requiring urgent surgical intervention to reconstruct the continuity of the esophagus and ensure the survival of the newborn," explains Dr. Alexander Siles, head of the Pediatric Surgery Service.

Standard Procedure

Traditionally, this problem was addressed through a thoracotomy; that is, a wide opening of the chest through a large incision in the chest of the newborn. However, in this case, the repair was performed thoracoscopically, introducing a small-caliber camera and the necessary instruments through three incisions of just 3 millimeters. This minimally invasive approach "allows for working with great precision in an extremely small and delicate anatomical space, in a patient just hours old, reducing surgical aggression and avoiding many of the sequelae associated with open surgery," points out the surgeon.

This highly complex technical intervention was carried out by the Hospital's Pediatric Surgery team, led by Dr. Alexander Siles, in close coordination with the Pediatric Anesthesiology team, the Neonatology team from the Pediatrics Service, and the Surgical Nursing team, whose participation was essential to safely address a procedure of this complexity in a newborn just 24 hours old. Dr. Paolo Bragagnini, a pediatric surgeon from Quirónsalud Zaragoza, a collaborator of the service and an expert in pediatric thoracic surgery, with extensive experience in neonatal thoracoscopic surgery, also participated.

"For me, this case represents much more than a surgery. It is the confirmation that, after years of work and with a highly specialized team, we can achieve the highest level of complexity in neonatal surgery in Málaga," says Dr. Alexander Siles

"For me, this case represents much more than a surgery. It is the confirmation that, after years of work and with a highly specialized team, we can also achieve the highest level of complexity in neonatal surgery in Málaga. And that changes what we can offer to our patients and their families today," explains Dr. Alexander Siles.

Complex Intervention

These types of interventions are considered among the most complex and demanding in all minimally invasive pediatric surgery and represent one of the greatest technical challenges of advanced neonatal surgery. Surgery of the chest in a newborn through a minimally invasive route requires an extremely high level of precision and experience on the part of the surgical team, as well as extremely precise coordination with the pediatric anesthesiology team.

And it is - he adds - that this milestone "reflects the maturity and capacity that our team has reached, as well as that of the hospital itself to address highly complex neonatal surgery safely and with guarantees. It represents a very important step forward in what we can offer to our patients and their families today."

The patient's progress has been favorable, allowing her hospital discharge and her return home with her family after the intervention.

For their part, the family of little Sofia, very grateful, highlights that "from the first moment we felt that our daughter was in the best hands. The peace and confidence that the team transmitted made a difference at such a difficult time for us."