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Open-fetal operation saves infant's life

It was an eleventh hour attempt to save the tiniest of lives. In some of the most dramatic video we've ever broadcast, see the hand of a five month old fetus -- held by a surgeon trying to give him a future. Rob Stafford reports.

High school sweethearts Russell and Jan Morrison shared the same dreams and were happily on their way to living them in Bonham, Texas.

Russell Morrison: Two kids and my wife and just… you know, a perfect little family.

Baby daughter Carson was the start of that perfect little family.  And in September 2005, Jan learned she was pregnant again.

Rob Stafford, Dateline correspondent: Are you hoping for a boy?Russell Morrison: I’m hoping for a boy but I’m happy either way.

But having their perfect family would take this couple on a medical odyssey far beyond anything they could have imagined. The odds were against them, the risks potentially fatal, the medical science turned mind-boggling.  Still Jan and Russell, together with a team of gifted doctors, set out to beat the odds.

It began in January 2006, five months into Jan’s pregnancy.  She had a sonogram to learn the sex of their baby.  It was a boy.

Stafford: Just what you want.Russell Morrison: Just what I wanted.Jan Morrison: I was excited but it was a very short-lived excitement.

It was short-lived because Jan was noticing this ultra sound was taking longer than others she’d had.

Jan Morrison: The lady that did the ultrasound… she kept focusing on one particular image.

The little boy they were hoping for had a huge tumor filling the left side of his chest. It covered his heart and was pushing it to the other side.  The prognosis was grim.

Jan Morrison: I was just mad.  I was excited about being pregnant and didn’t wanna lose my child and wanted to do something about it and I couldn’t find an answer.

Russel began researching his son’s condition, and where it might be treated. In February 2006, two weeks after first learning about the tumor, the Morrisons traveled to Houston to consult with specialists at Texas Children’s Hospital.  There the news was even worse.

Russell Morrison: We met with the cardiologist that morning and she told us that he was basically in heart failure.

The tumor appeared to have grown.  It was 3 inches large, filling the chest of a 5 month old fetus which weighed a mere pound and a half.  It was now squashing the heart, lungs, and diaphragm.  Blood wasn’t getting to the heart, which was rapidly failing.

Stafford: How much time does he have?Russell Morrison: They told us he had about a day and a half to live when we got there.

Jan and Russell decided all that was left to do was plan the inevitable.  At lunchtime they began making funeral arrangements.

Jan Morrison: That was the only thing I could do so couldn’t help my child so I did  what I could.

And they gave their son a name: Garrett.

Jan Morrison: It was my baby and he needed a name.  And just was wanting to name him while he was still alive.Russell Morrison: We needed something to put on his headstone.

With funeral arrangements underway, and seemingly out of hope, the Morrisons still had an afternoon meeting with more doctors.  Among them, fetal surgeons Darell Cass and Oluyinka Olutoye. Who said something the Morrison’s did not expect.

Stafford: Can you remove this tumor?Dr. Darrell Cass: Yes, we can.Stafford: This is doable?Dr. Darrell Cass: It is doable.

Doable, but these doctors would have to operate where few have ever tried—inside a mother’s womb.

Dr. Darrell Cass: It’s high-stakes surgery.  It’s the only thing we do where you have to go through a normal patient to get to a fetus—another patient that’s dying.

It was risky for both mother and child. Jan faced the possibility of never having children again or worse: bleeding to death during surgery. And there was no guarantee her son would survive. Still, without the operation she would definitely lose her baby.

Stafford: Is there any question in your mind whether you’re gonna go ahead with the surgery?Jan Morrison: No.  It was Garrett’s only shot, and I wanted to go with it.Stafford: How quickly do you need to operate?Dr. Darrell Cass: Within hours. The child had only limited time to survive.

On Feb. 7, 2006, 21 hours after arriving at Children’s hospital for consultations, doctors prepped Jan for surgery.

Surgeons will open the womb, remove the tumor from a tiny 5 month old fetus, then close the womb so the pregnancy can continue... all this without triggering labor.

An ultrasound showed the doctors the baby’s position.

And it guided them in determining where to open Jan’s uterus.

A half hour into the procedure, the uterus was safely opened, and Dr. Cass saw Garrett for the first time.

Dr. Darrell Cass: It’s always a fairly dramatic moment to see this very, very young fetus, this developing human that’s dying.

Garrett’s tiny chest had to be opened to remove the tumor.  To expose the chest, Dr. Olutoye had to raise Garrett’s left arm out of his mother’s womb.  Right in the operating room, the doctor found himself actually holding the hand of this 5 month old fetus, which weighed less than two pounds.

Dr. Oluyinka Olutoye:  Well, consider the size of my hand—being able to hold that tiny hand was actually quite dramatic.

Garrett now straddled two worlds.  Part of him was delivered, and part of him still inside his mother’s womb.  The doctors then opened his chest and found the tumor that was rapidly killing him.

Dr. Oluyinka Olutoye:  I don’t think either of us really anticipated how big it really was gonna be up close and personal.

The tumor was so large, it filled about two thirds of Garrett’s chest cavity.

Dr. Oluyinka Olutoye:  It was unbelievable that that size mass came out from such a small child.Stafford: Now they faced one of the trickiest parts of the procedure: putting Garrett back in his mother’s womb and closing it up as well.Dr. Oluyinka Olutoye: The last thing we want is for incision to pop loose and the baby come out of the uterus ruptured.

After two and a half hours in surgery, Dr. Cass gave Russell the news he’d hoped for.

Dr. Darrell Cass: Everything went fine for your wife.  Dr. Darrell Cass: He was doing as good as he can possibly be, but we were not out of the woods yet.

Garrett’s survival remained uncertain.  His heart could still stop, Jan could go into labor and deliver Garrett too early to survive. These next weeks were critical and Jan had to remain in the hospital, in bed. 

By the end of March, they were on the home stretch with just over six weeks to go. And Garrett’s chances of survival were getting better by the day.

Jan Morrison: The doctors are saying that Garrett looks like a normal 29 week old baby.  And that his lungs have developed.  And they’re looking normal and healthy.

But it was a temporary calm. Ten o' clock at night, Easter Sunday, April 16, 2006, Jan was bleeding and she was going into labor.  If her labor continued, it could rupture her uterus.

Dr. Darrell Cass: There was absolutely no choice.  Now was the time to deliver.

At 11:45 that night, Garrett was delivered, fighting for his life yet again.

Dr. Darrell Cass: Garrett comes out and he did look a little blue. Russell Morrison: They they took him and hit the doors running.Dr. Darrell Cass: I was worried. Did Garrett die somehow during this delivery process?  But then, he began to move.  And then, he began to cry.  And so, it really became clear that he was doing great. It was an incredible relief.  And a really a joyous, joyous moment.

The little fighter had made it two and a half months after miraculous surgery in his mother’s womb.

Stafford: You got your boy.Russell Morrison: I got my boy. It was all coming together just like we hoped for.

Finally in May 2006, the Morrison’s perfect little family was home at last.  Happy, and healthy.  The only sign of what this baby endured was the scar on his chest.

Stafford: You look at him now and what do you think?Jan Morrison: I think how perfect he looks.  After all he’s been through, he looks so good. He’s just a miracle and God’s gift.

Here, at eight months old, Garrett’s heart and lungs are strong.  His tumor was benign, no worry it will come back.  Doctors expect him to have a completely normal life

Russell Morrison: He’s had a pretty tough road, but he’s made it every step of the way.  He’s a little fighter.