OC124: A different technique for the correction of a ‘myelomeningocele‐like’ defect in ovine fetus

Abou-Jamra, Rogério C.; Oliveira, Rúbia Carla; Valente, Paulo Roberto; Araújo, A.; Saldiva, Paulo; Pedreira, D. A. L.

doi:10.1002/uog.2984

Cited by 1 publication

(5 citation statements)

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“…Our simplifications of the closure technique in rabbit and sheep fetuses [9][10][11] were important steps in the development of the present technique. Both Copeland et al [15] and Kohl et al [16] used time-consuming techniques, including using fibrin glue to fix maternal skin to the defect or suturing a dura mater substitute material to the lesion's edges, before closing the fetal skin with a 2-layer closure.…”

Section: Discussionmentioning

confidence: 99%

“…In the present study, only 1 suture layer was employed, making the closure simpler and faster. Additionally, these authors never tested their closure techniques on a case with a spinal defect, as we have [9][10][11] .…”

Section: Discussionmentioning

confidence: 99%

“…The interface material used has previously been tested by our group [10,11] . When we compared the acellular human dermal matrix, used in the majority of other studies [12,13] , to the biosynthetic cellulose used in the present study (a Brazilian product approved by the United States FDA in 1994), we found the cellulose much cheaper and more suitable for the correction.…”

Section: Discussionmentioning

confidence: 99%

“…With this objective, our group has developed a new, simple surgical technique to be applied for the endoscopic closure of the defect in an animal model. This technique was initially developed in the fetal rabbit [8,9] and subsequently applied in fetal sheep [10,11] .…”

Section: Introductionmentioning

confidence: 99%

“…In the present study, our aim was to develop a new endoscopic approach to apply the previously developed technique [8][9][10][11] to close a lumbar skin defect created in fetal sheep. To the best of our knowledge, this new technique has never been described before in the literature.…”

Section: Introductionmentioning

confidence: 99%

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Gasless Fetoscopy: A New Approach to Endoscopic Closure of a Lumbar Skin Defect in Fetal Sheep

et al. 2008

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Objective: To develop a new endoscopic approach to the correction of a myelomeningocele-like defect in fetal sheep. Methods: The fetuses of 9 pregnant ewes, with an average gestational age of 115 days, were subjected to a 3.0 × 2.0 cm removal of the skin over the lumbar spine, performed through hysterotomy. The uterus was closed, and three 5-mm endoscopic cannulas, without valve mechanisms, were inserted. In the pilot phase (2 animals), we initially worked exclusively in the amniotic fluid space. In the study phase, we partially withdrew the fetus from the amniotic fluid to completely expose its back. By simply allowing air to enter the amniotic cavity (without gas injection), a working space was created using a uterine lift device. The skin around the defect was dissected, and a biosynthetic cellulose material was applied to cover the area. A continuous suture of the skin was performed to completely hide the material. Results: The combined air/fluid space allowed the skin to be successfully closed in 6 out of 7 cases in the study phase. All fetuses were alive at the end of the procedures. Time to complete the endoscopic part of the procedure fell from 3 to 1 h by the end of this series. Premature birth occurred in 2 of the 4 cases allowed to continue with the pregnancy. Conclusion: A new gasless fetoscopic surgery technique was developed as an alternative to current techniques used for fetal endoscopic surgery.

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