Pediatric Experts Guide First of Its Kind Fetal Surgery in Germany

For the first time, a team of physicians in Heidelberg, Germany, performed a successful operation on an unborn child with myelomeningocele, a severe form of spina bifida, thanks to the ingenuity and expertise of SLUCare surgeons from Saint Louis University School of Medicine and the SSM Health St. Louis Fetal Care Institute.

Fetal Surgery

SLUCare physicians Mike Vlastos, M.D., FACOG, and Samer Elbabaa, M.D., FAANS, FACS.

That child, born just weeks ago, is doing well. 

The German team first spoke with SLUCare neurosurgeon Samer Elbabaa, M.D., FAANS, FACS, director of pediatric neurosurgery at SSM Health Cardinal Glennon Children’s Hospital, at an international medical conference.

Elbabaa is the Reinert Endowed Chair in Pediatric Neurosurgery and associate professor of neurosurgery at Saint Louis University School of Medicine.

After careful consideration and research, the German physicians knew Elbabaa and Mike Vlastos, M.D., FACOG, director of the SSM Health St. Louis Fetal Care Institute and an associate professor of maternal fetal medicine, would be the best fit to help guide them in implementing a successful fetal spina bifida surgical program of their own.

The team from Germany traveled to St. Louis to see the work of the Fetal Care Institute first-hand. The group, which included two maternal fetal medicine specialists, two neonatologists, two neurosurgeons and an anesthesiologist, toured the Fetal Care Institute at SSM Health Cardinal Glennon Children's Hospital, and observed clinic visits and a fetal myelomeningocele repair surgery at SSM Health St. Mary’s Hospital.

After studying the continued successful efforts in St. Louis, the German team performed their first spina bifida surgery at the University Hospital Heidelberg this spring. At their side were Vlastos and Elbabaa, who also participated in the procedure.

“This is a very exciting international collaboration between fetal neurosurgery and maternal fetal medicine teams across the ocean,” Elbabaa said. “Our fetal spina bifida surgery team is heavily involved in advancing the field by improving fetal surgery techniques as well as reducing maternal morbidity. Being able to help a mother and her fetus, now a healthy newborn, in Europe is a true honor and privilege. The collaboration with the Germany team at University Hospital Heidelberg was a terrific experience. A few other international teams have visited our program recently and we look forward to further expanding our national and international collaborations.” 

Myelomeningocele, a severe form of spina bifida, is caused when the bones in the back do not close over to protect the spinal cord. It may result in paralysis and brain damage before a baby is even born.

The SLUCare team at the Fetal Care Institute can repair the myelomeningocele while the baby is still in the womb. Research has shown that these efforts should help improve the chances for better leg, bladder and bowel function as well as reduce the need for brain shunt surgeries to treat hydrocephalus (fluid on the brain) after the baby is born.

Since the program opened in 2011, the Fetal Care Institute has performed more than 55 fetal myelomeningocele repairs.

“It is an honor to be involved in the development of an advanced fetal surgery program in Germany,” Vlastos said. “The world of fetal surgery is still a relatively new field of medicine, and we are fortunate to be able to help moms and babies around the world by increasing the availability of these life-changing fetal interventions.”

Vlastos is a fellow of the American College of Obstetrics and Gynecologists and a SLUCare high-risk OB-GYN specializing in fetal diagnosis and surgery.

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 The combined team of physicians from Saint Louis University and University Hospital Heidelberg.

The Fetal Care Institute, one of the largest and fastest growing fetal surgery centers in the United States and worldwide, has a collaborative team of SLUCare fetal and pediatric surgeons and maternal fetal medicine specialists working at SSM Health Cardinal Glennon Children’s Hospital and SSM Health St. Mary’s Hospital.


 SLUCare Physician Group is the academic medical practice of Saint Louis University, with more than 500 health care providers and 1,200 staff members in hospitals and medical offices throughout the St. Louis region. SLUCare physicians are among the most highly trained in their fields - more than 50 specialties in all - and are national and international experts, renowned for research and innovations in medicine.

 Established in 1836, Saint Louis University School of Medicine has the distinction of awarding the first medical degree west of the Mississippi River. The school educates physicians and biomedical scientists, conducts medical research, and provides health care on a local, national and international level. Research at the school seeks new cures and treatments in five key areas: infectious disease, liver disease, cancer, heart/lung disease, and aging and brain disorders.