But it wasn't until he took his two daughters to get their ears pierced--and noticed the woman behind the counter with piercings in her nose, eyebrow, and even cleavage--that he realized how to do it, and a device to manually open and close the esophagus was born.
Described as one of the world's first medicinal body piercings, the experimental device works by pulling on a tiny metal pin extending out of the skin of the patient's neck to move the larynx forward and open the esophagus.
With colleague Gregory Farwell, Belafsky flew down to Uruguay in August to implant the prototype piercing in the throat of an Uruguayan physician and cancer survivor who hadn't been able to swallow for two years; the patient relied instead on a feeding tube after undergoing chemotherapy and radiation treatments for tonsil cancer. (The device is not yet FDA approved, so they performed the surgery in the patient's home country.)
At a hospital in Montevideo, Belafsky and Farwell spent just 45 minutes suturing the T-shaped titanium device into the cricoid cartilage that circles the trachea and then required that the patient wait a few months before using the device to ensure the incision site fully healed and the device was well-integrated into the cartilage.
"By attaching a tiny titanium rod to a postage stamp-sized plate that we've sewn into the neck cartilage, we've enabled our patient to safely and without pain pull on the device to move his larynx forward and open the esophagus to allow food and liquid to pass," Belafsky says. "It's the first time a person has been able to manually control the entryway to the esophagus."
After monitoring the incision site from afar and then performing extensive testing on the patient at UC Davis in November, the surgeons are now pronouncing the implant a success. Belafsky says that UC Davis has already patented the technology; the next step is to get FDA approval to conduct clinical trials in the U.S., and funding those trials is his primary concern.
"I get constant e-mails from patients who can't eat," he says. "We are hoping for a very wealthy donor to step in and help us."
Meanwhile Daniel Fiandra, the Uruguayan patient, is recovering back in South America, where he will practice swallowing, not to mention drinking, for the first time in more than two years. And all that, Belafsky says, with what "just looks like a small piece of jewelry."