Fetal surgery

[dangit]

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Anybody have info on how to become a fetal surgeon?

I love being in the OR and want to be involved in Obgyn. Is it possible to do through Obgyn/ MFM?

I've recently became interested and I've tried searching through SDN and google and have found limited info. If anyone could provide info or point me in the right direction, I would greatly appreciate it. thanks!

 

[J-Rad]

I'm not an expert in the area of fetal surgery, but the field is in the purview of the pediatric surgeon. Peds ENTs and urologists may also become involved in some fetal or perinatal procedures. There are also some procedures done by pediatric interventional cardiologists in utero (in particular aortic valvuloplasty to see if severe AS can be prevented from becoming HLHS). OB/GYNs do assist in the management of the mother in a collaborative environment, but for reasons that make sense, they are not the surgeons doing the procedure on the baby.

 

[FutureDoc734]

I spoke recently with an MFM fellow about this topic. In these situations, the MFM does the hysterotomy and/or fetoscopy. If a procedure is to be performed on the baby, then the fetal surgeon steps in. Both specialties work corabollatively to make it happen. In order to become a fetal surgeon, you have to go through general surgery residency, then pedi surg fellowship, then further subspecialize in fetal surgery.

 

[Global Disrobal]

In the realm of fetal intervention and surgery, you'll find a great deal of overlap between fetal therapy trained pediatric surgeons and fetal intervention trained MFM providers.

In its current state, the fetal trained pediatric surgeons (such as those who've graduated from CHOP, UCSF, TCH) will get involved to the degree that they are comfortable with fetal interventions in conjunction with the fetal intervention MFM team. The specific roles depend on the culture at the institution and the procedure at hand. For example, you'll find at some institutions that the pediatric surgeon and the MFM will perform the hysterotomy, and the neurosurgeon will close the MMC defect (in cases of ONTD), whereas it some centers (especially Europe), the pediatric surgeon may do the entire procedure themselves, and again in other locales the MFM does the procedure with the neurosurgeon doing the fetal repair. Then there are cases such as EXIT to resection (MFM does the EXIT and the surgeon the resection), laser for TTTS (MFM/FI generally does the entire procedure), aortic valvuloplasty where the MFM inserts the trocar in the LV and the Interventional cardiologist threads the coronary catheter through the LVOT… In summary, my response to you is: it depends on the location, the team, and the procedure.

If you want to go the OB route, then you're looking at a 4 year residency, 3 year MFM fellowship, and then some form of fetal intervention training.

If you want to go the surgery route, then as mentioned above, you're looking at a pediatric surgery track with some research and fetal specific training.

Hope this is helpful!

 

[Entadus]

In the realm of fetal intervention and surgery, you'll find a great deal of overlap between fetal therapy trained pediatric surgeons and fetal intervention trained MFM providers.

In its current state, the fetal trained pediatric surgeons (such as those who've graduated from CHOP, UCSF, TCH) will get involved to the degree that they are comfortable with fetal interventions in conjunction with the fetal intervention MFM team. The specific roles depend on the culture at the institution and the procedure at hand. For example, you'll find at some institutions that the pediatric surgeon and the MFM will perform the hysterotomy, and the neurosurgeon will close the MMC defect (in cases of ONTD), whereas it some centers (especially Europe), the pediatric surgeon may do the entire procedure themselves, and again in other locales the MFM does the procedure with the neurosurgeon doing the fetal repair. Then there are cases such as EXIT to resection (MFM does the EXIT and the surgeon the resection), laser for TTTS (MFM/FI generally does the entire procedure), aortic valvuloplasty where the MFM inserts the trocar in the LV and the Interventional cardiologist threads the coronary catheter through the LVOT… In summary, my response to you is: it depends on the location, the team, and the procedure.

If you want to go the OB route, then you're looking at a 4 year residency, 3 year MFM fellowship, and then some form of fetal intervention training.

If you want to go the surgery route, then as mentioned above, you're looking at a pediatric surgery track with some research and fetal specific training.

Hope this is helpful!

Necrobump for a GREAT post with some awesome info!!