Keeping it simple: a “two-step” approach for the fetoscopic correction of spina bifida

Lapa, D.A.

doi:10.1007/s00464-010-1006-1

Cited by 8 publications

(9 citation statements)

References 9 publications

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“…( 8 ) Although the long-term effects of this new technique are not yet know, it has the potential to prevent the neurological damage inherent to the neurosurgical repair technique, demonstrated for the first time in this study. ( 9 )…”

Section: Discussionmentioning

confidence: 99%

Fetoscopy for meningomyelocele repair: past, present and future

Bevilacqua

Lapa

2015

Einstein (São Paulo)

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Meningomyelocele is a malformation with high prevalence, and one of its main comorbidities is Arnold-Chiari malformation type II. The intrauterine repair of this defect has been studied to reduce the progressive spinal cord damage during gestation. The purpose of the present review was to describe the evolution of fetal surgery for meningomyelocele repair. Searches on PubMed database were conducted including articles published in the last 10 years. Twenty-seven articles were selected, 16 experimental studies and 11 studies in humans. A recent study demonstrated that the fetal correction results in better prognosis of neurological and psychomotor development, but open surgery, which has being used widely, has considerable maternal risks. Studies in animal and human models show that the endoscopic approach is feasible and leads to lower maternal morbidity rates. Two endoscopic techniques are currently under assessment - one in Germany and another in Brazil, and we believe that the endoscopic approach will be the future technique for prenatal repair of this defect.

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Section: Discussionmentioning

confidence: 99%

Fetoscopy for meningomyelocele repair: past, present and future

Bevilacqua

Lapa

2015

Einstein (São Paulo)

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“…Promisingly, it has been shown that the placement of a bilaminar artificial skin (a silicone and an acellular dermal matrix layer) over a cellulose graft can successfully keep the graft in place without necessitating a change in surgical techniques used. 16 In particular, it was observed that not only was the dermal matrix repopulated, but also that a neoepidermis was produced on top of it. This led the authors to conclude that a new skin had formed over the cellulose graft, thereby protecting it from dislodgement.…”

Section: Origin Of the Fetoscopic Approachmentioning

confidence: 99%

“…This led the authors to conclude that a new skin had formed over the cellulose graft, thereby protecting it from dislodgement. 16…”

Section: Origin Of the Fetoscopic Approachmentioning

confidence: 99%

“…5 The surgical approach undertaken in Brazil represents more than a decade of animal work and more than two decades of operative fetoscopy experience. 7,8,[14][15][16][17] With this approach, percutaneous fetoscopic surgery for OSB is performed via three or four trocars. Using the Seldinger technique, vascular introducers and a balloontipped laparoscopic trocar are placed into the amniotic cavity under continuous ultrasound monitoring.…”

Section: Growth and Adoption Of The Fetoscopic Approach (Safer Technimentioning

confidence: 99%

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A Fetoscopic Approach for Antenatal Correction of Open Spina Bifida

Sá¹,

Acácio²,

Pedreira³

2016

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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“…Separated studies reported a higher incidence of fetal death, intraoperative complications, and suboptimal outcomes [47][48][49] . Accumulation of experiences and modifications of endoscopic surgical techniques have been made, and outcome data from the endoscopic approach is catching up [50] . An important progress for endoscopic approach was the implementation of single-layer repair and biocellulose patch for defect closure, pioneered by groups in Brazil and Germany, respectively.…”

Section: Appropriate Training For In Utero Repair Of MMCmentioning

confidence: 99%

Establishing Prenatal Surgery for Myelomeningocele in Asia: The Singapore Consensus

et al. 2017

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Objectives: The Management of Myelomeningocele Study (MOMS Trial) has inspired many fetal therapy centers (FTCs) to offer open fetal surgery for myelomeningocele (MMC). This is an initial effort to create a candidate model that can be applicable to many parts of Asia. Material and Methods: A limited selection of specialists from 4 established FTCs in Thailand, Hong Kong, India, and Singapore met for a round table discussion. Experts from Children's Hospital of Philadelphia (CHOP) involved in the Trial moderated the session. The practice suggestions in this statement were from a targeted literature review and expert opinion. Results: A high prevalence of MMC in Asia supports an effort to adopt the procedure, but only in established FTCs with good maternal and neonatal ancillary supports. The falling incidence of MMCs may affect case volume and maintenance of skill. A regional approach was recommended. Fetal benefits have to be weighed against maternal risks, with a consideration of recent outcome data from the endoscopic approach. Responsible FTCs need standardized diagnosis and management, with their long-term outcome data available for an audit. Conclusions: It is envisaged that the information presented by this multidisciplinary team would be useful for FTCs in Asia or elsewhere that plan to establish more advanced fetal care in the future.

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Keeping it simple: a “two-step” approach for the fetoscopic correction of spina bifida

Cited by 8 publications

References 9 publications

Fetoscopy for meningomyelocele repair: past, present and future

Fetoscopy for meningomyelocele repair: past, present and future

A Fetoscopic Approach for Antenatal Correction of Open Spina Bifida

Establishing Prenatal Surgery for Myelomeningocele in Asia: The Singapore Consensus

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