Swallowing food is goal for Ricardo

JAMES GIBBARD / Tulsa World

Yahoska Jimenez Martinez waits with her son, Ricardo Jose Hernandez Jimenez, 5, to be seated at the Diocesan Shrine of Our First Lady of Guadalupe church in Tulsa on April 8. Ricardo, who was born without an esophagus, underwent a six-hour procedure on Monday called a colon interposition, which doctors believe will allow him to eat and drink.

By KIM ARCHER World Staff Writer
4/24/2007

Physicians perform delicate surgery on the child, 5, who was born without an esophagus.

Five-year-old Ricardo Hernandez Jimenez may soon be able to swallow his first bite of food following a six-hour operation Monday to give the boy an esophagus.

"Everything went absolutely perfect," said Dr. Warren Pagel, who arranged Ricardo's lifesaving journey and was the anesthesiologist for the Nicaraguan boy's surgery. "We couldn't have asked for the operation to go any better than it did."

Ricardo, who was born without an esophagus, went into surgery early Monday at St. John Medical Center, which provided all surgical care and hospitalization at no charge.

Pediatric surgeons Drs. Subramania Jegathesan and Richard Ranne, who both are affiliated with St. Francis Hospital, donated their services to perform a complex procedure called a colon interposition.

In the operation, surgeons took a section of Ricardo's colon and connected it from his stomach to his neck.

The segment of colon was placed directly behind his breastbone, and a major artery also was pulled from the stomach to the neck to provide a blood supply, Ranne said.

Ricardo's remaining colon was reconnected during a delicate procedure to allow normal bowel function.

"We perform one or two of these surgeries each year. It doesn't replace the normal anatomy, and it can create new problems," Ranne said. "But without it, Ricardo's life expectancy isn't very good."

With the surgery, Ricardo has a great chance for normalcy. In fact, one of Ranne's former patients on whom he performed this procedure years ago recently got married and had a baby, he said.

"I think Ricardo will do well with it," he said.

Normally, doctors try to save what esophagus might be available to them, but Ricardo's undeveloped esophagus had retracted into his abdomen and was nearly nonexistent, Ranne said.

Ricardo will be sedated for two days in pediatric intensive care to allow the surgical wounds to heal.

"He's is one strong little boy when he wakes up. He's had a lot of stimulation from games and toys, so we want him to have time to heal," Ranne said.

Ricardo arrived in Tulsa with his mother, Yahoska Jimenez Martinez, the day before Easter and immediately was evaluated for the surgery.

"He was very sick with malnourishment and infection. But he responded very well to treatment," Ranne said.

The malnourishment was a result of being fed through a feeding tube in his stomach his entire life, he said. The boy also had a yeast infection around a hole in his throat where saliva drained out.

"The two weeks we spent treating his infection and malnutrition was time well-spent for him," Ranne said.

It could be a week or more before young Ricardo attempts to take a drink of liquid or eat a bite of soft food, Ranne said.

"Mom is extremely appreciative and quite excited at the prospect of her child being able to eat normally," he said.