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With the aid of special magnifying glasses and scaled- down instruments, physicians--such as this one--who specialize in the delicate and dramatic techniques of minisurgery, return otherwise doomed babies to life. A Start dun* J oey was bom in a New Jersey hospital at 3:30 a.m., weighed about SVi pounds--and was in danger of losing his life. X-rays showed that his esophagus, instead of leading from his throat down to his stomach in one long continuous tube, was in two segments. The upper part ended somewhere in his chest, while the lower end joined his trachea. "Esophageal atresia," was the diagnosis, a common--but potentially deadly--birth defect. Survival meant it had to be totally corrected within hours. It was--and today, Joey is a normal, 'healthy 4-year-old. Like thousands of other children, he owes his life to a medical specialty known as minisur- gery--surgery on the very, very young. Using incredibly delicate techniques, ^ doctors have operated successfully on Â£ prematufe infants weighing slightly a over a pound. Some operations have Â£ been conducted less than an hour after J birth. w Nearly - every American university S hospital and children's hospital has be- by Jonathan Braun come a center for minisurgery--and hospital physicians in any given area are familiar with their nearest center. Right after Joey's illness was diagnosed, a call was put in to New York Hospital-Cornell Medical Center. Head pediatric surgeon Dr. S. Frank Redo lis- tened as a New Jersey doctor described the baby's condition. "Get him here as soon as possible," said Dr. Redo. Joey was placed in a special incubator for the 40-mile ambulance ride to New York City. Upon arrival, he was transferred to an "isolette," a Plexiglas- covered incuBator. on wheels, with "portholes" through which staff members can perform blood transfusions, administer oxygen and give other emergency services. Just six hours after he was born-after undergoing blood tests and additional X-rays, Joey was operated on by Dr. Redo and a team of skilled assistants. The operation, which connected both ends of the infant's tiny esophagus, was a complete success. There was a time, however; when babies born with esophageal atresia--as well as countless other birth defects--were almost certain to die. 'Nothing is routine' "Minisurgery is a relatively new field," says Dr. Redo. "Operations that were considered tremendous undertakings 20 years ago are now relatively routine, although with these cases nothing is really routine." The concept of major, lifesaving surgery on infants had its beginnings.in the late 1930's at Boston Children's Hospital..There, great advances were made by an almost legendary group of pediatric surgeons trained and led first by Dr. William E. Ladd, then by Dr. Robert E. Gross. According to Dr. Redo, "The Boston . group's real accomplishment was the realization that the infant is not just a little adult--that the infant has its own "* special problems and requires a good deal of special care before, during and Â· after the operation." Pre-operative care is vitally important in minisurgery, especially, as in Joey's case, when the patient has to be transported from one hospital to another. Says Dr. Redo: "Probably the most significant development in surgery on premature and high-risk newborn patients has been the perfection of transport techniques such as those perfected by our unit" The critical point 'The idea is to get the baby safely to the regional center while maintaining - the highest quality care," explains Dr. Alvin Hackel, who manages a West Coast interhospital transport system at the.Stanford University Medical Center. "When we get a call from one of our 55 referral hospitals we usually dispatch a team consisting of a nurse arid at least one highly trained specialist. After consulting with the other doctors, our people take over responsibility for the baby. This is the critical point--from then on the quality of care must be maintained." On their first day on earth, some in. fants fly over 300 miles to get to Stanford. Many are brought by helicopter to a heliport only 700 feet from the emergency room entrance. Others are brought by airplane, then transported by ambulance. continued A top m/n/surgeon, Dr. S. Frank Redo, is shown treating a patient through the "portholes" of an "isolette" which is a. P/ex/g/as-covered incubator on wheels.