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Doctors do first brain surgery on fetus

NASHVILLE, Tenn. -- Surgeons opened a woman's uterus and performed brain surgery on a fetus last March to relieve a buildup of water on the brain, a surgical first, doctors said Friday.

The baby was born two months later showing no signs of congenital hydrocephalus -- also called water on the brain, Dr. Joseph Bruner and Dr. Noel Tulipan said Friday at Vanderbilt University Medical Center.The doctors have used the procedure 49 times over the past two years to repair spina bifida lesions in the womb. They said it was the first time the procedure was used on the brain.

They acknowledge they won't know for six months to a year -- until they can measure Neal Borkowski's IQ -- whether he suffered any serious brain damage but say "he's developing now like a normal baby would."

"We really have to hedge our bets as to how he'll do over the long run," Tulipan said. But the fact that he was born without excess fluid on the brain makes the March 2 surgery a success, he said. Neal was born May 12.

The baby's mother, Susan Borkowski of Knoxville, said she learned during a routine ultrasound that her 20-week-old fetus had hydrocephalus. About one in every 2,000 babies is born with congenital hydrocephalus and most are severely brain damaged.

"It wasn't really a decision," she said of the choice to try the experimental surgery. When she was 6, her brother died of hydrocephalus shortly after he was born.

In the procedure, Susan Borkowski's uterus was opened by Bruner, then Tulipan made an incision in the fetus' skull and placed a shunt, or small tube, in the fluid space of the brain.

The opposite end of the shunt was hooked to a small valve controlling the flow of fluid. The valve was connected to a long, thin tube that was tunneled out through the baby's skin between the shoulder blades and the fluid drained into Susan Borkowski's uterus.