The evangelist of fetal surgery

The evangelist of fetal surgery

There are only about 12 places in the United States that perform fetal surgery, a highly specialized field in which surgeons, through a tiny incision in the mother’s abdomen, operate on babies that have been developing for as little as 15 weeks.

One doctor, Dr. Timothy Crombleholme, has been responsible for starting over half those programs, and he’s on the cusp of bringing this niche field into the mainstream into hundreds of hospitals across the country.

The father of fetal surgery

Dr. Crombleholme isn’t the father of fetal surgery. That title belongs to Dr. Michael Harrison, who authored the case report in the New England Journal of Medicine that Crombleholme encountered when he was a student at the Tufts University School of Medicine in the 1980s.

In it Harrison explained how he had cut directly into the uterus to fix a structural abnormality that was throwing off a fetus’s amniotic fluid volume. Crombleholme was hooked. He took off for residency at the University of California, San Francisco and eventually was accepted for a fetal surgery research fellowship there under the direction of Harrison himself.

Since then Dr. Crombleholme has been the primary force spreading fetal surgery to other U.S. hospitals.

First he returned to Tufts, his alma mater, where he got in on the ground floor of Tuft Medical Center’s fetal surgery program. Then came the Children’s Hospital of Philadelphia and the University of Pennsylvania, where he helped found the Center for Fetal Diagnosis and Treatment.

Several years later he founded the fetal care program at Cincinnati Children’s Hospital Medical Center. Next he founded the Fetal Care Center at the Children’s Hospital Colorado while serving as their surgeon in chief.

Scaling fetal surgery nationwide

Which brings us to 2018, when Crombleholme accepted an offer to bring open fetal surgery to North Texas via the The Fetal Care Center at Medical City Dallas, which is under the umbrella of national hospital operator HCA Healthcare — about 180 hospitals responsible for 220,000 deliveries every year.

HCA wanted Crombleholme to do what he’d been doing — establishing fetal surgery programs — but on a much, much larger scale. The plan is to have Medical City Dallas serve as the national center for the most demanding and complicated surgeries while Crombleholme establishes standards for Level 2 and Level 3 centers across the HCA network.

According to Crombleholme: “Ideally, we would have these geographically distributed across the country with requisite expertise and resources to take care of patients close to home when possible and, if not, they would come here.”

Check out the complete article published in D Magazine here: The Surgeon Who Works On Babies Before They’re Born

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