Surgery Scheduled!

Dr. Rouse reviewed the films with us and wants to do surgery tomorrow, around 11AM Eastern Time. This news is good and bad. The CT shows he does have lung tissue nearly all the way down, but it is compressed from the front by the liver and the heart, and they don't know how well the lungs are developed - but they are there. They have him rolled over on his belly now with the ventilator going to help expand the lungs and get better volume. Ultimately they need to get the liver out of the way to really see how the lungs can do, which is why they are doing surgery tomorrow.

Here are the risks:
Bleeding: The liver is what needs to be moved and it is easily injured and also bleeds easily. Also he is on heparin, a blood thinner, for the ECMO which increases the risks for bleeding. Even if things go well in surgery, bleeding could start at a later time as well.
ECMO: B/c of the O2 levels being a little on the low side still, they can't wean any lower like they usually would. If he has a lot of trouble after, they won't be able to turn up the support much more than what he is already. Also, they will need to do some of the surgery with him on his back, and some with him on his tummy, which means he will have to be turned with the cannulaes in his neck.
Blood vessels: B/c the liver developed up in the chest instead of the abdomen, the blood vessels developed there too. Moving the liver down poses risks for stretching or kinking the vessels.

They also mentioned that there will probably not be enough room in the abdomen for the intestine once the liver is moved back down, so they will have to leave some of it out and gradually work it back in over a few days (the intestines will be up in a "volcano shaped" cone). I get the impression that this is fairly routine in such a case and this is the least of our worries.