In a landmark achievement on July 14, a medical team at the capital Ankara’s Hacettepe University Children’s Hospital performed Türkiye’s first closed in-womb surgery, successfully repairing a neural tube defect in a 26-week-old fetus.
The anomaly, affecting brain and spinal cord development, was detected via ultrasound when Sebiha Çakmak, 32, was 22 weeks pregnant at Kastamonu Training and Research Hospital in the northern province of Kastamonu. She was transferred to Hacettepe University Perinatology Clinic.
An interdisciplinary team of 30 specialists, including endoscopic surgery expert Associate Professor Dr. Derman Başaran, conducted a fetoscopic operation that lasted six and a half hours with international support from Professor Dr. Alireza Shamshirsaz. Surgeons accessed the womb using milimetric instruments and a camera to close the spinal opening.
A day earlier on July 13, the university’s adult hospital performed an open surgical repair on another fetus with a similar condition. Completing both within 24 hours made Hacettepe University the first center in Türkiye offering open and closed options for neural tube defects.
Expecting her seventh child after six healthy pregnancies, Çakmak recalled being advised to terminate the pregnancy over disability concerns. “I refused. We had fears, but overcame them thanks to our doctors. It is a miracle, and we plan to name our boy Umut,” Çakmak said.
The closed procedure leaves a much smaller incision and requires vast coordination among neurosurgery, anesthesia, perinatology and endoscopic surgery departments, Hacettepe University Perinatology Department head Prof. Dr. Özgür Deren said. “We thank our administrators, particularly Rector Professor Dr. Mehmet Cahit Güran,” he said.
Early repair prevents severe nerve damage, increases the baby’s independent walking chances and allows the mother a vaginal birth, perinatology academic Associate Professor Dr. Erdem Fadıloğlu
said.
Children with this defect face leg movement restrictions, bowel control difficulties and hydrocephalus. “Closing it blocks amniotic fluid exposure, repairs leaks and minimizes hydrocephalus complications,” Neurosurgery Department academic Professor Dr. İlkay Işıkay said.
Noting that the fetus receives anesthesia to prevent movement and block pain perception, Anesthesia and Reanimation Department academic Professor Dr. Banu Kılıçaslan said, “We apply anesthesia to two beings simultaneously, which requires serious preparation.”
