An experimental model of gastroschisis using fetoendoscopy

Guys, Jean Michel; Esposito, Ciro; Simeoni, J.; D’ercole, C.; Paut, O.; Bouzid, Aïcha; Boubli, L.

doi:10.1007/s00464-001-9033-6

Cited by 14 publications

(2 citation statements)

References 12 publications

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“…A fetal sheep model of gastroschisis which was created by a hybrid approach (maternal laparotomy, manipulation of the uterus, and transuterine fetoscopy) was treated with amnioinfusion by an implantable port implanted during creation of the gastroschisis: a total of 46.7% of the fetuses survived the procedure, an amniotic infection occurred in 34.6% of cases. It could be demonstrated that continuous amnioinfusion appears technically feasible by implanted port devices [61].…”

Section: Animal Interventionsmentioning

confidence: 99%

Fetal Surgery for Gastroschisis—A Review with Emphasis on Minimally Invasive Procedures

et al. 2022

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(1) Background: The morbidity of gastroschisis is defined by exposure of unprotected intestines to the amniotic fluid leading to inflammatory damage and consecutive intestinal dysmotility, the viscero-abdominal disproportion which results in an abdomen too small to incorporate the herniated and often swollen intestine, and by associated pathologies, such as in complex gastroschisis. To prevent intestinal damage and to provide for growth of the abdominal cavity, fetal interventions such as amnio exchange, gastroschisis repair or covering have been evaluated in several animal models and human trials. This review aims to evaluate the reported techniques for the fetal treatment of gastroschisis by focusing on minimally invasive procedures. (2) Methods: We conducted a systematic database search, quality assessment and analyzed relevant articles which evaluate or describe surgical techniques for the prenatal surgical management of gastroschisis in animal models or human application. (3) Results: Of 96 identified reports, 42 eligible studies were included. Fetal interventions for gastroschisis in humans are only reported for EXIT procedures and amnio exchange. In animal models, particularly in the fetal sheep model, several techniques of open or minimally invasive repair of gastroschisis or covering the intestine have been described, with fetoscopic covering being the most encouraging. (4) Discussion: Although some promising minimally invasive techniques have been demonstrated in human application and animal models, most of them are still associated with relevant fetal morbidity and mortality and barely appear to be currently applicable in humans. Further research on specific procedures, instruments and materials is needed before any human application.

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Section: Animal Interventionsmentioning

confidence: 99%

Fetal Surgery for Gastroschisis—A Review with Emphasis on Minimally Invasive Procedures

et al. 2022

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“…In their recent article describing a fetoendoscopic sheep model of gastroschisis, Guys et al [10] cited our experience with amniotic fluid exchange under the term ''amnioinfusion.'' However, the procedure of amniotic fluid exchange differs from amnioinfusion.…”

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confidence: 99%

Amniotic fluid exchange vs amniofusion in gastroschisis

Akgür

Olguner

2003

Surg Endosc

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Is there a role for fetal interventions in gastroschisis management? – An updated comprehensive review

et al. 2020

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We conducted a comprehensive evidence‐based review on the epidemiology and current standard of care of gastroschisis management as well as the pathophysiology, rationale and feasibility of fetal therapy as a viable alternative. Gastroschisis is a periumbilical abdominal wall defect characterized by abdominal viscera herniation in utero. It affects 4 in 10 000 live births, but the prevalence has steadily increased in recent years. Gastroschisis is typically diagnosed on routine second‐trimester ultrasound. The overall prognosis is favorable, but complex gastroschisis, which accounts for about 10% to 15% of cases, is associated with a higher mortality, significant disease burden and higher healthcare costs due to long‐ and short‐term complications. The current standard of care has yet to be established but generally involves continued fetal surveillance and multidisciplinary perinatal care. Postnatal surgical repair is achieved with primary closure, staged silo closure or sutureless repair. Experimental animal studies have demonstrated the feasibility of in utero closure, antiinflammatory therapy and prenatal regenerative therapy. However, reports of early preterm delivery and amnioinfusion trials have failed to show any benefit in humans. Further experimental studies and human trials are necessary to demonstrate the potential benefit of fetal therapy in gastroschisis.

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An experimental model of gastroschisis using fetoendoscopy

Abstract: Our experience shows that this experimental model of gastroschisis is feasible and reproducible, and that a repeated amnioinfusion can be performed with an in-dwelling catheter in pregnant ewes. The use of an implantable port is safer than a simple exteriorized catheter.

Cited by 14 publications

References 12 publications

Fetal Surgery for Gastroschisis—A Review with Emphasis on Minimally Invasive Procedures

Fetal Surgery for Gastroschisis—A Review with Emphasis on Minimally Invasive Procedures

Amniotic fluid exchange vs amniofusion in gastroschisis

Is there a role for fetal interventions in gastroschisis management? – An updated comprehensive review

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