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First in the World: Pancreatic Surgery on Pregnant Woman at Rambam

RHCC

In a groundbreaking medical achievement, Rambam Health Care Campus (Rambam) in Haifa, Israel successfully performed the world’s first pancreatic surgery on a pregnant woman to treat life-threatening hypoglycemia. The patient who was six months pregnant, underwent a series of unprecedented surgical procedures that saved her life and the life of her unborn child.


Meshi Portal (23), diagnosed with multiple sclerosis and wheelchair-bound, conceived through in vitro fertilization after facing fertility challenges. In her 18th week of pregnancy, she suddenly lost consciousness, which led to her hospitalization. After a series of advanced medical tests, results revealed critically low blood sugar levels, indicating severe hypoglycemia.


Dr. Safi Khuri, an attending physician at the General Surgery Section in Rambam’s Division of Surgery, suspected that the patient had a benign pancreatic tumor that was causing excessive insulin production. Given the complexities of Portal’s condition and the potential risks to the fetus, the medical team faced a critical decision between drug therapies and surgical intervention. Considering the unknown effects of drug therapies on fetal development, the team opted for surgery.


Meshi with Dr. Khuri.  Photo: Courtesy of the family
Meshi with Dr. Khuri. Photo: Courtesy of the family

The initial surgery aimed to locate and remove the tumor; however, intraoperative assessments did not reveal a detectable mass. Despite temporary improvements post-surgery, Portal’s condition deteriorated, necessitating a second operation two weeks later. Her physicians identified an overgrowth of insulin-producing beta cells and performed a second surgery to remove the affected tissue.


Following the surgeries, Portal’s health stabilized, and she delivered a healthy baby boy via a cesarean section in the 32nd week of pregnancy. After giving birth, Portal switched to drug therapies, but she continued to suffer from life-threateningly low blood sugar levels. A third surgery followed and her entire pancreas was removed, resulting in Type 1 diabetes. Her son, also required surgery and was treated at Rambam’s neonatal intensive care unit for three months. Today, he has recovered well, and he is healthy and thriving. After an extensive literature and case review, the surgical team determined that was the first time a successful pancreas removal was performed on a pregnant woman.


Although Portal is now learning how to manage her diabetes while caring for her infant, she is grateful to her medical team, especially Dr. Khuri: "I have an insulin pump and I'm still trying to figure out how to deal with my illness. I've had a lot of health problems, but I'm very lucky to have had a top-notch doctor. My doctor has become a close friend. He saved me physically and mentally, and also as a mother. Thanks to him, I'm a mother.”


This pioneering medical intervention saved her life and also set a precedent for treating similar cases worldwide. Dr. Khuri highlights the significance of this achievement: “Meshi’s pregnancy and underlying health conditions presented unique challenges. Our multidisciplinary approach and the successful outcome demonstrate the capabilities of modern medicine to navigate such complex scenarios.”


Rambam continues to be a leader in medical innovations, providing advanced care, and setting new standards in patient treatment.


Contact

8 HaAliyah Hashniya St., Bat Galim, Haifa 3109601​​​​

info@rmc.gov.il

*5324 or 04-7775368 - Service and Information Center

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