Gasless fetoscopy: a new approach to endoscopic closure of a lumbar skin defect in fetal sheep

Fetal Diagnosis and Therapy
Denise Araújo Lapa PedreiraPaulo Hilário Saldiva

Abstract

To develop a new endoscopic approach to the correction of a myelomeningocele-like defect in fetal sheep. The fetuses of 9 pregnant ewes, with an average gestational age of 115 days, were subjected to a 3.0 x 2.0 cm removal of the skin over the lumbar spine, performed through hysterotomy. The uterus was closed, and three 5-mm endoscopic cannulas, without valve mechanisms, were inserted. In the pilot phase (2 animals), we initially worked exclusively in the amniotic fluid space. In the study phase, we partially withdrew the fetus from the amniotic fluid to completely expose its back. By simply allowing air to enter the amniotic cavity (without gas injection), a working space was created using a uterine lift device. The skin around the defect was dissected, and a biosynthetic cellulose material was applied to cover the area. A continuous suture of the skin was performed to completely hide the material. The combined air/fluid space allowed the skin to be successfully closed in 6 out of 7 cases in the study phase. All fetuses were alive at the end of the procedures. Time to complete the endoscopic part of the procedure fell from 3 to 1 h by the end of this series. Premature birth occurred in 2 of the 4 cases allowed to continue with...Continue Reading

Associated Clinical Trials

References

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Citations

Apr 1, 2010·Surgical Endoscopy·Denise Araújo Lapa Pedreira
Jun 29, 2011·Future Neurology·Payam SaadaiDiana L Farmer
Aug 19, 2011·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Denise Araújo Lapa PedreiraPaulo Hilário Nascimento Saldiva
Dec 5, 2013·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Denise A L PedreiraRuben A Quintero
Jun 12, 2012·Clinics in Perinatology·Payam Saadai, Diana L Farmer
Sep 20, 2015·American Journal of Obstetrics and Gynecology·Denise A L PedreiraRubén A Quintero
Jun 30, 2009·Clinics in Perinatology·Shinjiro Hirose, Diana L Farmer
Mar 21, 2009·Obstetrics and Gynecology·Nancy C Chescheir
Jun 9, 2016·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·D A L PedreiraR A Quintero
Mar 1, 2010·Einstein·Denise Araujo Lapa PedreiraPaulo Hilário Nascimento Saldiva
Feb 7, 2013·Einstein·Silvia Rejane Fontoura HerreraDenise Araujo Lapa Pedreira
Aug 2, 2021·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Lourenço SbragiaHélio Rubens Machado
Jun 6, 2021·American Journal of Obstetrics and Gynecology·Magdalena Sanz CortesKypros H Nicolaides
Apr 22, 2021·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·D A LapaK H Nicolaides

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