This paper is only available as a PDF. To read, Please Download here.
Abstract
Open spina bifida (OSB) is the most common congenital anomaly of the central nervous
system compatible with life. Prenatal repair of open spina bifida via open maternal-fetal
surgery has been shown to improve postnatal neurological outcomes, including reducing
the need for ventriculoperitoneal shunting and improving lower neuromotor function.
Fetoscopic repair of OSB minimizes the maternal risks while providing similar neurosurgical
outcomes to the fetus. Two fetoscopic techniques are currently in use: (1) the laparotomy-assisted
approach, and (2) the percutaneous approach. The laparotomy-assisted fetoscopic technique
appears to be associated with less risk of preterm birth compared to the percutaneous
approach. However, the percutaneous approach avoids laparotomy and uterine exteriorization,
and is associated with less anesthesia risk and improved maternal post-surgical recovery.
The purpose of this paper is to describe our experience with a novel surgical approach,
which we call percutaneous/mini-laparotomy fetoscopy (PML), in which access to the
uterus for one of the ports is done via a mini-laparotomy, while the other ports are
inserted percutaneously. This technique draws on the benefits of both the laparotomy-assisted
and the percutaneous techniques, while minimizing their drawbacks. This surgical approach
may prove invaluable in the prenatal repair of open spina bifida as well as other
complex fetal surgical procedures.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of Obstetrics & GynecologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
Article Info
Publication History
Accepted:
May 16,
2022
Received in revised form:
May 15,
2022
Received:
November 5,
2021
Publication stage
In Press Journal Pre-ProofFootnotes
Disclosure Statement: The authors report no conflict of interest.
Condensation: A new fetoscopic technique for the antenatal repair of open spina bifida, percutaneous/mini-laparotomy, draws on the benefits and minimizes the risks of both the laparotomy-assisted and the percutaneous surgical approaches.
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
