Modification of the gasless fetoscopy technique for the treatment of large myelomeningocele: a study in sheep

Pedreira, D. A. L.; Acácio, Gregório Lorenzo; Abou-Jamra, Rogério C.; Oliveira, Rúbia Carla; Caldini, Elia Garcia; Saldiva, Paulo Hilário Nascimento

doi:10.1590/s1679-45082010ao1440

Cited by 2 publications

(2 citation statements)

References 15 publications

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“…Using the gasless technique, the researchers avoided the problem of rapid changes in intrauterine pressure when inserting and withdrawing trocars and laparoscopic instruments in this study. In 2010, Pedreira et al [31] improved the technique with smaller diameter laparoscopic instruments, reducing premature rupture of the membrane in postoperative clinical courses. Moreover, the group proposed a two-step approach for fetoscopic correction in this model, in which the first step was the simple intrauterine coverage of the defect followed by definitive postnatal neurosurgical correction to reduce fetal mortality.…”

Section: Applications Of Fetoscopic Ovine Modelmentioning

confidence: 99%

Evolution and Variations of the Ovine Model of Spina Bifida

Lee¹,

Du²,

Hassan³

et al. 2023

Fetal Diagn Ther

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Spina bifida is the most common congenital anomaly of the central nervous system and the first non-fatal fetal lesions to be addressed by fetal intervention. While research in spina bifida has been performed in rodent, non-human primate and canine models, sheep have been a model organism for the disease. This review summarizes the history of development of the ovine model of spina bifida, previous applications, and translation into clinical studies. Initially used by Meuli et al., fetal myelomeningocele defect creation and in utero repair demonstrated motor function preservation. The addition of myelotomy in this model can reproduce hindbrain herniation malformations, which is the leading cause of mortality and morbidity in humans. Since inception, the ovine models have been validated numerous times as the ideal large animal model for fetal repair, with both locomotive scoring and spina bifida defect scoring adding to the rigor of this model. The ovine model has been used to study different methods of myelomeningocele defect repair, the application of various tissue engineering techniques for neuroprotection and bowel and bladder function. The results of these large animal studies have been translated into human clinical trials including MOMS (Management of Meningocele Study) trial that established current standard of care for prenatal repair of spina bifida defects, and the ongoing trials including the CuRe (Cellular Therapy for In Utero Repair of Myelomeningocele) trial using a stem cell patch for repair. The advancement of these live saving and life altering therapy began in sheep models, and this notable model continues to be used to further the field including current work with stem cell therapy.

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Section: Applications Of Fetoscopic Ovine Modelmentioning

confidence: 99%

Evolution and Variations of the Ovine Model of Spina Bifida

Lee¹,

Du²,

Hassan³

et al. 2023

Fetal Diagn Ther

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“…Aiming at the development of a new endoscopic approach to the correction of MMC, Pedreira et al [103] assessed the gasless fetoscopy approach. By allowing air to enter the amniotic cavity through cannulas without valve mechanisms (and without gas injection), they created a working space using a uterine lift device and suggested that the gasless technique is an adequate alternative for fetal endoscopic surgery [103,109].…”

Section: Surgical Techniquementioning

confidence: 99%

State of the art in translating experimental myelomeningocele research to the bedside

et al. 2021

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Myelomeningocele (MMC), the commonest type of spina bifida (SB), occurs due to abnormal development of the neural tube and manifest as failure of the complete fusion of posterior arches of the spinal column, leading to dysplastic growth of the spinal cord and meninges. It is associated with several degrees of motor and sensory deficits below the level of the lesion, as well as skeletal deformities, bladder and bowel incontinence, and sexual dysfunction. These children might develop varying degrees of neuropsychomotor delay, partly due to the severity of the injuries that affect the nervous system before birth, partly due to the related cerebral malformations (notably hydrocephalus-which may also lead to an increase in intracranial pressure-and Chiari II deformity). Traditionally, MMC was repaired surgically just after birth; however, intrauterine correction of MMC has been shown to have several potential benefits, including better sensorimotor outcomes (since exposure to amniotic fluid and its consequent deleterious effects is shortened) and reduced rates of hydrocephalus, among others. Fetal surgery for myelomeningocele, nevertheless, would not have been made possible without the development of experimental models of this pathological condition. Hence, the aim of the current article is to provide an overview of the animal models of MMC that were used over the years and describe how this knowledge has been translated into the fetal treatment of MMC in humans.

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Modification of the gasless fetoscopy technique for the treatment of large myelomeningocele: a study in sheep

Cited by 2 publications

References 15 publications

Evolution and Variations of the Ovine Model of Spina Bifida

Evolution and Variations of the Ovine Model of Spina Bifida

State of the art in translating experimental myelomeningocele research to the bedside

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