Minimally invasive fetoscopic interventions: an overview in 2010

Kohl, Thomas

doi:10.1007/s00464-010-0879-3

Cited by 16 publications

(7 citation statements)

References 105 publications

(102 reference statements)

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“…Keywords Endoscopic laser surgery Á High-speed camera Á Laser fiber Á Minimally invasive surgery Á Endoscope Endoscopic laser surgery is becoming increasingly popular in areas such as fetal surgery, neurosurgery, ophthalmology, urology, and otolaryngological surgery [1][2][3][4][5][6]. Conventional procedures use surgical tools for both diagnosis (e.g., endoscope, CCD camera) and treatment (laser device), which requires two incisions.…”

Section: Resultsmentioning

confidence: 99%

A novel ultrasmall composite optical fiberscope

et al. 2011

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Section: Resultsmentioning

confidence: 99%

A novel ultrasmall composite optical fiberscope

et al. 2011

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“…During MOMS, all other centers in North America discontinued comparable surgical activities. Parallelly open and foetoscopic surgery was performed in single centers around the globe, the largest series are reported from Poland [10] (open), Germany [11,12] (foetoscopic) and recently from Brazil, [13] but not under controlled study conditions.…”

Section: Historical Backgroundmentioning

confidence: 99%

“…The endoscopic interventionalist himself indicates that he is offering endoscopic treatment to a very select group of patients. [11,12] In order to get more evidence regarding the clinical results of this technique, several independent colleagues, pediatric neurologists as well as neurosurgeons collected data from patients followed by them with those who were primarily treated foetoscopically. In these randomly collected patient groups the shunt incidence was as high as in regularly treated patients, although shunts were put in many cases after the sixth month.…”

Section: Experience With Foetoscopic MMC Closurementioning

confidence: 99%

Role of fetal surgery in spinal dysraphism

Messing-Jünger¹

2017

IJNS

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Open spinal dysraphism is a common and clinically challenging organo-genetic malformation. Due to the well-known multi-organ affection with significant implication on the lives of patients and their families, abortion after prenatal diagnosis became reality in most parts of the world. After publication of the Management of Myelomeningocele Study (MOMS) results fetal surgery seems to be a new option and a broad discussion arose regarding advantages and risks of in utero treatment of spina bifida. This paper tries to evaluate objectively the actual state of knowledge and experience. This review article gives a historical overview as well as the experimental and pathophysiological background of fetal surgery in open spinal dysraphism. Additionally clinical follow-up experience of foetoscopically treated patients are presented and discussed. After carefully outweighing all available information on fetal surgery for spina bifida, one has to conclude, in accordance with the MOMS investigators, that in utero surgery cannot be considered a standard option at present time. But there is clear evidence of the hypothesis that early closure of the spinal canal has a positive influence on spinal cord function and severity of Chiari malformation type II, has been proven. A persisting problem is the fetal risk of prematurity and the maternal risk of uterus damage. There is also evidence that due to technical restrictions, fetal closure of the spinal canal bears unsolved problems leading to a higher postnatal incidence of complication surgery. Finally, missing long-term results make a definite evaluation impossible so far. At the moment, fetal surgery in open spinal dysraphism is not a standard of care despite promising results regarding central nervous system protection due to early spinal canal closure. Many technical problems need to be solved in the future in order to make this option a safe and standard one.

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“…The vast majority of fetuses with complete larynx atresia die because the condition is not recognized prenatally and not treated immediately at birth, or because of other life-threatening anomalies. Only a few fetuses have been saved by ex-utero intrapartum treatment (EXIT) (4,15,16) or fetoscopic decompression of the trachea (17) while the fetus is still connected with the placenta.…”

Section: B Anterior View Of Opened Thorax and Abdomen Showing Large mentioning

confidence: 99%

Isolated laryngeal atresia, prenatal diagnosis and pathology. Case report.

Nemescu¹

2015

Gineco.eu

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Congenital high airway obstruction syndrome (CHAOS) is a rare disorder defined as any fetal abnormality that obstructs the larynx or trachea. Most cases are sporadic with an unknown incidence. We report a case that was diagnosed prenatally at 21 gestational weeks, which showed a typical CHAOS pattern with expanded hyperechogenic lungs, inverted diaphragms, dilated trachea and ascites. There were no other fetal abnormalities and the karyotype was normal (46xy). The parents opted to have an elective termination of pregnancy. Pathological examination confirmed the diagnosis, showing infraglottic atresia (type II) and complete trachea obstruction. The disease is incompatible with life, and antenatal ultrasound diagnosis is advisable. However, few cases have been reported which managed with neonatal interventions such as ex-utero intrapartum treatment.

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Minimally invasive fetoscopic interventions: an overview in 2010

Cited by 16 publications

References 105 publications

A novel ultrasmall composite optical fiberscope

A novel ultrasmall composite optical fiberscope

Role of fetal surgery in spinal dysraphism

Isolated laryngeal atresia, prenatal diagnosis and pathology. Case report.

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