Format

Send to

Choose Destination
Fetal Diagn Ther. 2019;45(1):36-41. doi: 10.1159/000485655. Epub 2018 Feb 21.

Two-Port Fetoscopic Repair of Myelomeningocele in Fetal Lambs.

Author information

1
Department of Fetal Medicine, Armand Trousseau Hospital, APHP, Sorbonne University, UPMC Paris 6 University, Paris, France.
2
Department of Pediatric Orthopaedics, Armand Trousseau Hospital, Sorbonne University, UPMC Paris 6 University, Paris, France.
3
Department of Histology, Necker Hospital, APHP, Paris, France.
4
Department of Pediatric Neurosurgery, Necker Enfants Hospital, APHP, Paris 5 University, Paris, France.
5
Department of Fetal Medicine, Armand Trousseau Hospital, APHP, Sorbonne University, UPMC Paris 6 University, Paris, Francejean-marie.jouannic@trs.aphp.fr.

Abstract

OBJECTIVE:

The aim of this study was to assess the feasibility and the effectiveness of a fetoscopic myelomeningocele (MMC) repair with a running single suture using a 2-port access in the sheep model.

METHODS:

Eighteen fetuses underwent surgical creation of a MMC defect at day 75. Fetuses were then randomized into 3 groups. Four fetuses remained untreated (control group). In the other 14 fetuses, a prenatal repair was performed at day 90: 7 fetuses had an open repair (oMMC), and 7 fetuses had a fetoscopic repair (fMMC) using a single-layer running suture through a 2-port access. Lambs were sacrificed at term, and histological examinations were performed.

RESULTS:

Hindbrain herniation was observed in all live lambs in the control group. A complete closure of the defect was achieved in all the lambs of the fMMC group. A complete healing of the defect and no hindbrain herniation were observed in all live lambs of the oMMC and fMMC groups. The durations of surgeries were not statistically different between the oMMC and the fMMC groups (60 vs. 53 min, p = 0.40), as was the risk of fetal loss (fMMC: 1/7, oMMC: 3/7, p = 0.56).

DISCUSSION:

Fetoscopic repair of MMC can be performed using a single-layer running suture through a 2-port access and may be promising to reduce the risk of premature rupture of membranes.

KEYWORDS:

Fetal lambs; Fetal surgery; Myelomeningocele; Spina bifida; Two-port fetoscopy

PMID:
29466789
DOI:
10.1159/000485655
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for S. Karger AG, Basel, Switzerland
Loading ...
Support Center