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Published in: Child's Nervous System 7/2017

01-07-2017 | Focus Session

Fetoscopic patch coverage of experimental myelomenigocele using a two-port access in fetal sheep

Authors: Lucie Guilbaud, Nathalie Roux, Stéphanie Friszer, Charles Garabedian, Ferdinand Dhombres, Bettina Bessières, Catherine Fallet-Bianco, Federico Di Rocco, Michel Zerah, Jean-Marie Jouannic

Published in: Child's Nervous System | Issue 7/2017

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Abstract

Purpose

This study aims to assess the feasibility and the effectiveness of a fetoscopic myelomeningocele (MMC) coverage using a sealed inert patch through a two-port access, in the sheep model.

Methods

Forty-four fetuses underwent surgical creation of a MMC defect at day 75 and were divided into four groups according to the MMC repair technique, performed at day 90. Group 1 remained untreated. Group 2 had an open surgery using suture of the defect. Groups 3 and 4 underwent defect coverage using a Gore®-polytetrafluoroethylene patch secured with surgical adhesive (Bioglue®), with an open approach (group 3) and a fetoscopic one (group 4). Lambs were killed at term, and histological examinations were performed.

Results

Fetoscopic patch coverage was achieved in all the lambs of group 4. All the fetuses of group 2 had a complete closure of the defect whereas only 38% in group 3 and 14% in group 4. Fetal loss rate seems to be lower in group 4 than in groups 2 and 3.

Conclusion

Fetoscopic coverage of MMC defect can be performed using a sealed patch through a two-port access, but the patch and glue correction may not be the ideal technique to repair fetal MMC.
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Metadata
Title
Fetoscopic patch coverage of experimental myelomenigocele using a two-port access in fetal sheep
Authors
Lucie Guilbaud
Nathalie Roux
Stéphanie Friszer
Charles Garabedian
Ferdinand Dhombres
Bettina Bessières
Catherine Fallet-Bianco
Federico Di Rocco
Michel Zerah
Jean-Marie Jouannic
Publication date
01-07-2017
Publisher
Springer Berlin Heidelberg
Published in
Child's Nervous System / Issue 7/2017
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-017-3461-7

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