Cutting-Edge Procedure For Children’s Cancer Leaves Minimal Scars

The tumor in infant Joshua “Jak” Kaltenbach’s abdomen was nearly as big as his heart, about the size of a walnut. But instead of open, invasive surgery and a long, complicated healing process, Jak had to stay only one night in the hospital, took far less pain medication and has scars (if they can be called that) that are nearly invisible. These more patient-friendly circumstances are the direct result of a new, specialized procedure offered locally only at the MCG Children’s Medical Center.

For the Kaltenbachs, the worry began when ultrasound revealed a mass during mom Tanya’s pregnancy. A whirlwind of events followed, starting with Jak’s premature delivery, his hospitalization due to an unrelated case of necrotizing entercolitis (a bowel inflammation common in preemies) and finally, monthly ultrasound screenings of Jak’s belly to check on the tumor.

“A number of infants are born with tumors like Jak’s and amazingly, as the tumors mature, they often become benign,” said Dr. Walt Pipkin, head of the Center for Minimally Invasive Surgery for Children at the MCG Children’sMedicalCenter. “That’s something unique that often happens with these types of adrenal tumors. But in Jak’s case, that wasn’t to be.”

Just before Christmas, when Jak was four months old, the radiologist reported sobering news to the Kaltenbachs: The tumor had grown and it had grown a lot. Subsequent tests confirmed that the tumor was a neuroblastoma, a cancer of the body’s nerve network that manifests in solid tumors in the abdomen, chest, neck or head.

Jak had to have surgery. But not just any kind of surgery. Dr. Pipkin, who had been following Jak’s case since his hospitalization at the MCG Children’sMedicalCenter, removed the tumor using a new minimally invasive approach in the center’s high-tech endosuite. Jak’s case was the first ever to be performed at the children’s hospital, and only a few centers across the country offer this type of specialized approach.

During the procedure, Dr. Pipkin made several tiny incisions in Jak’s belly button and on his stomach. Ports were then inserted, which allowed him to use specialized tools, including a camera, to find the tumor. Watching his every move on a video screen, Dr. Pipkin pinpointed the mass, carefully disconnected it, placed it in a bag, and removed it through one of the small ports. A few small stitches and some Steristrips later, Jak was back in his hospital room and with his family.

The Kaltenbachs had a one-night stay at the MCG Children’sMedicalCenter, compared to four nights with conventional open surgery. To control pain, Jak had morphine the first night, but switched to Tylenol following that. A week and a half later, the Steristrips fell off, and his healing was well on its way. “He didn’t want to be on his tummy of course and there was a little swelling, but other than that, he did wonderfully,” said Mrs. Kaltenbach. “He never even got cranky. And his scars are so tiny, less than a quarter-inch across. If you didn’t know they were there, you wouldn’t even see them.”

“Because of our high-tech endosuite, we were able to offer Jak and his family a minimal access solution to a potentially large problem,” said Dr. Pipkin. “The tumor was completely removed, and we’re very glad that we could be here for this family when they needed us.”

MCG Health System is composed of three organizations – MCG Health Inc. and the clinical services offered by the faculty of the Medical College of Georgia and the members of the MCG Physicians Practice Group.  MCG Health, Inc. is a not-for-profit corporation operating theMCGMedicalCenter, MCG Children’sMedicalCenter, theMCGSportsMedicineCenter,MCGMCGHealthMedicalOfficeBuilding, theGeorgiaRadiationTherapyCenterand related clinical facilities and services.  MCG Health, Inc. was formed to support the research and education mission of the Medical College of Georgia, and to build the economic growth of the CSRA, the state of Georgia and the Southeast by providing an environment for delivering the highest level of primary and specialty health care.

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