Tracheomalacia

At Children’s Hospital Boston, we’re known for our science-driven approach. In fact, we’re home to the world's most extensive pediatric hospital research enterprise; and we partner with elite health care and biotech organizations around the globe. But as specialists in innovative, family-centered care, our physicians never forget that your child is precious, and not just a patient.

Until recently, esophageal atresia—a condition that often occurs with tracheomalacia—was a condition with no truly satisfactory treatment options. Previous treatments involved stressful stretching of the esophagus, drastic repositioning of internal organs or using transplanted tissue to build a replacement esophagus.

The revolutionary Foker method encourages natural growth and strengthening of a child’s existing esophagus with the end result being a normal, functioning esophagus.

The idea

John Foker, MD, a pediatric surgeon from the University of Minnesota, knew that a fetus’ normal esophagus develops due to the tension placed on it by growing bones. To encourage this same tension-induced elongation for children with EA following a baby’s birth, he surgically attached traction sutures to the tiny esophageal ends and increased the tension on these sutures, bit by bit. To date, all of the patients treated with this method are able to eat and swallow like other children.

How it works

• at least two operations are required
• first operation attaches traction sutures to both ends of the esophagus
• tension increases on the sutures over the course of several days or weeks (depending on length of the gap)
• traction sutures stimulate upper and lower ends of the esophagus to grow
• another operation removes sutures and joins esophageal ends

Bringing the Foker process to Children’s Hospital Boston

After inventing this process, Foker met with skepticism from his peers. Fortunately, Children’s surgeon Russell Jennings, MD, emerged as one believer. In 2009, Jennings visited Foker in Minnesota to assist him in operations employing the Foker process.

Jennings is now putting his education to use at Children’s. Together with Bradley Linden, MD, he’s established Children’s Esophageal Advanced Treatment Center, the world’s only center offering the Foker process.