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Newborn boy bounces back after micro-incision surgery

Just as Katie Rosenau held her son Caleb for the first time and took in the tuft of strawberry blond hair she’d seen on the ultrasound, he was choking and turning purple, and was whisked away from her.

A special small baby “ambulance” drove him from Millard Fillmore Suburban Hospital to the neonatal intensive care unit at Women & Children’s Hospital in Buffalo. Her husband, Joel, followed in their car.

Instead of cuddling with her new son, she spent that January night alone at the Williamsville hospital.

“That was really hard,” said Rosenau. “It was overwhelming at times.”

It turned out Caleb’s esophagus was disconnected so when he swallowed, food couldn’t go to his stomach. One end attached to the trachea so air went to the lungs and the stomach. The rare condition had to be fixed. Two days after he was born, Caleb was scheduled for surgery.

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On Tuesday, April 26, thousands of volunteers will help sell a special Kids Day edition of The Buffalo News. The proceeds from the sale of this special edition are presented to Variety, the Children’s Charity, to benefit Women and Children’s Hospital of Buffalo, the Robert Warner MD Center for Children with Special Needs, Children’s Charities of Western New York and Cradle Beach.

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Instead of the standard surgical repair of opening the chest and rib cage to get at the esophagus, a new-to-Buffalo pediatric surgeon took a dramatically different approach. Carroll Harmon, who left the University of Alabama to become surgeon in chief at Children’s two years ago, is a practiced advocate of a less invasive technique.

The more Rosenau learned, the surer she felt. “I felt so confident the doctor was going to be able to fix everything,” she said.

“Thoracoscopic” repair involves tiny incisions and instruments, like a telescope camera just 4 millimeters wide. Doctors would manipulate their tools to repair Caleb’s esophagus while watching the camera’s inside view of their work on big, high-definition TV monitors.

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The day before the surgery, Rosenau’s 33rd birthday, the family went to see Caleb in his neonatal crib. He was so connected to tubes that his mother couldn’t hold him. Instead she rubbed his back and kissed him. His two brothers – William, 6, and Ryan, 3 – drew colorful crayon pictures for the wall.

“It was hard just seeing your baby all hooked up,” she said. “As a mom, you want to hold him and snuggle him.”

On Jan. 24, a typical gray winter morning, the four- to five-hour procedure began. It was the first of its kind to be done in Buffalo. Family from all over the country, and the world, prayed for him – from her mother-in-law, doing missionary work in Ghana, to her Marine brother-in-law stationed in Japan.

Working in an area of just 2½ square centimeters, Harmon first separated the esophagus from the trachea. Then he sewed the disconnected pieces together. “Everything has just gone beautifully,” he said. “I was glad it all went the way the book says it’s supposed to go.”

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Harmon, past president of the International Pediatric Endo Surgery Group, is working to make surgeries like this, with very small incisions, increasingly common with babies. Already, there have been a couple hundred surgeries removing infant appendixes and gall bladders through belly buttons.

“We’re pushing the envelope in other ways,” Harmon said.

Caleb healed more swiftly than anyone expected. A week after the procedure, the tubes came out and Rosenau held and fed her son at the hospital. Two weeks later, he went home with five little scar dots on his right side, and normal baby life began.

Eating, sleeping and grinning at his mother.

“Hi there, smiley boy,” Rosenau said, holding him on her lap and leaning close. “He’s really a sweetheart. Very snuggly.”

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As she talked on a recent afternoon, her mother dropped off Caleb’s older brothers from school at the family’s sunny square brick house in Williamsville.

Three-year-old Ryan played with a small collection of superheroes, while 6-year-old William remembered what it was like when he first saw Caleb at the hospital.

“I was kind of confused,” William said.

Worried, he kept Caleb in his bedtime prayers and made two pictures to hang over the hospital crib.

One showed his brother frowning with an X-ray view with the esophagus in two pieces. The other had his brother all connected and smiling, like he was that afternoon.

William leaned close to Caleb sitting on his mother’s knee. “Hi! Hi!” he said. He likes thinking about future fun they’ll all have.

“When he gets older, it’s going to be cool because all three of us can battle with our lightsabers.”

email: mkearns@buffnews.com