Foker Process

The Foker process can be performed on newborns and children as small as 7 pounds (3.5 kg). The process takes anywhere from several weeks to several months to complete, depending on the severity of your child’s condition. Because the process allows your child grow his/her own esophagus, surgically transplanting other parts of the digestive tract (like the colon or stomach) is not needed. This approach may also reduce the risk of infection, eating difficulties and malnutrition.

During the Foker process:

  1. Your child will be fully sedated.
  2. Your child’s surgeon will make an incision on the back of the chest. Unlike traditional treatments, which require large incisions on the abdomen as well as the neck and chest, the Foker process results in fewer incisions and smaller scars.
  3. The surgeon will place four or five sutures (stiches) on the upper and lower ends of your child's esophagus. These are tiny stitches that connect the ends to the outside.
  4. The tension on the sutures will be increased bit by bit, causing each end of the esophagus to grow about one to two millimeters each day—just like a muscle grows when you exercise it. This will create just enough growth for the two ends to be attached. Depending on how much your baby's esophagus needs to grow, this typically may take between one and three weeks.
  5. For the Foker process to be successful, your baby will need to be motionless during the time the esophagus is being stretched, because excessive motion might pull out the sutures. Medication will be provided to keep your child still. During this time, your child will stay in the intensive care unit on a ventilator (breathing machine).
  6. Once the esophagus has grown to the desired length, we remove the sutures and sew together the ends of the esophagus.

The Foker process works best when used as the initial treatment. It can sometimes be used after other long-gap EA treatments, such as colonic interposition or a gastric pull-up have failed, but experience has shown that this is not ideal.

This extraordinary procedure often results in an esophagus that is indistinguishable from one that has developed normally on esophagrams.

Make an Appointment

To make an appointment or speak with a member of our team, please call 617-355-3038.

International Patients

For families residing outside of the United States, please call Boston Children's International Health Services at +01-617-355-5209.