Modification of the gasless fetoscopy technique for the treatment of large myelomeningocele: a study in sheep
ABSTRACT Objective: To change the gasless fetoscopy technique in order to reduce the diameter of entry orifices in the myometrium. Methods: Seven pregnant ewes were submitted to fetoscopy for repairing a large skin defect measuring 4.0 × 3.0 cm, created in the fetal lumbar region at the gestationa...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Instituto Israelita de Ensino e Pesquisa Albert Einstein
2010-03-01
|
| Series: | Einstein (São Paulo) |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082010000100018&tlng=en |
| _version_ | 1819284377031409664 |
|---|---|
| author | Denise Araujo Lapa Pedreira Gregório Lorenzo Acácio Rogério Chaccur Abou-Jamra Rita de Cássia Sanches Oliveira Elia Garcia Caldini Paulo Hilário Nascimento Saldiva |
| author_facet | Denise Araujo Lapa Pedreira Gregório Lorenzo Acácio Rogério Chaccur Abou-Jamra Rita de Cássia Sanches Oliveira Elia Garcia Caldini Paulo Hilário Nascimento Saldiva |
| author_sort | Denise Araujo Lapa Pedreira |
| collection | DOAJ |
| description | ABSTRACT Objective: To change the gasless fetoscopy technique in order to reduce the diameter of entry orifices in the myometrium. Methods: Seven pregnant ewes were submitted to fetoscopy for repairing a large skin defect measuring 4.0 × 3.0 cm, created in the fetal lumbar region at the gestational age of 100 days. The defect was repaired through continuous suture of the skin with approximation of borders. Gasless fetoscopy was used for performing the suture with three orifices to allow entry of the trocar into the myometrium. A 5.0-mm optical trocar, and 3.5-mm grasping, dissecting and suturing forceps were used. After surgery, pregnancy was maintained until the animals were euthanized on the 133rd day of gestation, and the fetuses were evaluated. Results: Seven pregnant ewes underwent surgery; the first two cases were characterized as the Pilot Group, in which the endoscopic technique was modified and caliber reduction was possible in two out of three entry orifices in the myometrium. In the five remaining cases (Study Group), the repair was successfully carried out in all the fetuses, and the mean duration of fetoscopy was 98 minutes. There was a case of maternal death attributed to intrauterine infection. Mean intrauterine permanence after surgery was 12 days. Conclusions: The technique was successfully modified, allowing reduction of the uterine orifices necessary to perform the repair of a skin defect in the fetal lumbar region through a new fetoscopy technique. The impact of this modification in repair of myelomeningocele in human fetuses should be studied. |
| first_indexed | 2024-12-24T01:46:24Z |
| format | Article |
| id | doaj.art-5ef674cce3c547368d47fc87bca7a118 |
| institution | Directory Open Access Journal |
| issn | 2317-6385 |
| language | English |
| last_indexed | 2024-12-24T01:46:24Z |
| publishDate | 2010-03-01 |
| publisher | Instituto Israelita de Ensino e Pesquisa Albert Einstein |
| record_format | Article |
| series | Einstein (São Paulo) |
| spelling | doaj.art-5ef674cce3c547368d47fc87bca7a1182022-12-21T17:21:50ZengInstituto Israelita de Ensino e Pesquisa Albert EinsteinEinstein (São Paulo)2317-63852010-03-0181182310.1590/s1679-45082010ao1440Modification of the gasless fetoscopy technique for the treatment of large myelomeningocele: a study in sheepDenise Araujo Lapa PedreiraGregório Lorenzo AcácioRogério Chaccur Abou-JamraRita de Cássia Sanches OliveiraElia Garcia CaldiniPaulo Hilário Nascimento SaldivaABSTRACT Objective: To change the gasless fetoscopy technique in order to reduce the diameter of entry orifices in the myometrium. Methods: Seven pregnant ewes were submitted to fetoscopy for repairing a large skin defect measuring 4.0 × 3.0 cm, created in the fetal lumbar region at the gestational age of 100 days. The defect was repaired through continuous suture of the skin with approximation of borders. Gasless fetoscopy was used for performing the suture with three orifices to allow entry of the trocar into the myometrium. A 5.0-mm optical trocar, and 3.5-mm grasping, dissecting and suturing forceps were used. After surgery, pregnancy was maintained until the animals were euthanized on the 133rd day of gestation, and the fetuses were evaluated. Results: Seven pregnant ewes underwent surgery; the first two cases were characterized as the Pilot Group, in which the endoscopic technique was modified and caliber reduction was possible in two out of three entry orifices in the myometrium. In the five remaining cases (Study Group), the repair was successfully carried out in all the fetuses, and the mean duration of fetoscopy was 98 minutes. There was a case of maternal death attributed to intrauterine infection. Mean intrauterine permanence after surgery was 12 days. Conclusions: The technique was successfully modified, allowing reduction of the uterine orifices necessary to perform the repair of a skin defect in the fetal lumbar region through a new fetoscopy technique. The impact of this modification in repair of myelomeningocele in human fetuses should be studied.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082010000100018&tlng=enFetoscopy/methodsFetal therapies/methodsMeningomyelocele/surgerySheep/abnormalitiesDisease models, animalSurgical procedures, operativeSuture techniquesUltrasonographyVideo-assisted surgery |
| spellingShingle | Denise Araujo Lapa Pedreira Gregório Lorenzo Acácio Rogério Chaccur Abou-Jamra Rita de Cássia Sanches Oliveira Elia Garcia Caldini Paulo Hilário Nascimento Saldiva Modification of the gasless fetoscopy technique for the treatment of large myelomeningocele: a study in sheep Einstein (São Paulo) Fetoscopy/methods Fetal therapies/methods Meningomyelocele/surgery Sheep/abnormalities Disease models, animal Surgical procedures, operative Suture techniques Ultrasonography Video-assisted surgery |
| title | Modification of the gasless fetoscopy technique for the treatment of large myelomeningocele: a study in sheep |
| title_full | Modification of the gasless fetoscopy technique for the treatment of large myelomeningocele: a study in sheep |
| title_fullStr | Modification of the gasless fetoscopy technique for the treatment of large myelomeningocele: a study in sheep |
| title_full_unstemmed | Modification of the gasless fetoscopy technique for the treatment of large myelomeningocele: a study in sheep |
| title_short | Modification of the gasless fetoscopy technique for the treatment of large myelomeningocele: a study in sheep |
| title_sort | modification of the gasless fetoscopy technique for the treatment of large myelomeningocele a study in sheep |
| topic | Fetoscopy/methods Fetal therapies/methods Meningomyelocele/surgery Sheep/abnormalities Disease models, animal Surgical procedures, operative Suture techniques Ultrasonography Video-assisted surgery |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082010000100018&tlng=en |
| work_keys_str_mv | AT denisearaujolapapedreira modificationofthegaslessfetoscopytechniqueforthetreatmentoflargemyelomeningoceleastudyinsheep AT gregoriolorenzoacacio modificationofthegaslessfetoscopytechniqueforthetreatmentoflargemyelomeningoceleastudyinsheep AT rogeriochaccuraboujamra modificationofthegaslessfetoscopytechniqueforthetreatmentoflargemyelomeningoceleastudyinsheep AT ritadecassiasanchesoliveira modificationofthegaslessfetoscopytechniqueforthetreatmentoflargemyelomeningoceleastudyinsheep AT eliagarciacaldini modificationofthegaslessfetoscopytechniqueforthetreatmentoflargemyelomeningoceleastudyinsheep AT paulohilarionascimentosaldiva modificationofthegaslessfetoscopytechniqueforthetreatmentoflargemyelomeningoceleastudyinsheep |