© 2013 Informa UK Ltd. This provisional PDF corresponds to the article as it appeared upon
acceptance. Fully formatted PDF and full text (HTML) versions will be made available soon.
DISCLAIMER: The ideas and opinions expressed in the journal’s Just Accepted articles do not necessarily reflect those of Informa Healthcare (the Publisher), the Editors or
the journal. The Publisher does not assume any responsibility for any injury and/or damage to persons or property arising from or related to any use of the material contained
in these articles. The reader is advised to check the appropriate medical literature and the product information currently provided by the manufacturer of each drug to be
administered to verify the dosages, the method and duration of administration, and contraindications. It is the responsibility of the treating physician or other health care
professional, relying on his or her independent experience and knowledge of the patient, to determine drug dosages and the best treatment for the patient. Just Accepted
articles have undergone full scientific review but none of the additional editorial preparation, such as copyediting, typesetting, and proofreading, as have articles published
in the traditional manner. There may, therefore, be errors in Just Accepted articles that will be corrected in the final print and final online version of the article. Any use of the
Just Accepted articles is subject to the express understanding that the papers have not yet gone through the full quality control process prior to publication.
Just Accepted by The Journal of Maternal-Fetal & Neonatal Medicine
Fetoscopic single-layer repair of open spina bifida using a cellulose
patch: preliminary clinical experience.
Denise A.L. Pedreira, Nelci C. Zanon, Renato A.M. de Sá, Gregório L.
Acacio, Edilson Ogeda, Teresa M.L.O.U. Belem, Ramen H. Chmait,
Eftichia Kontopoulos, Ruben A. Quintero
doi: 10.3109/14767058.2013.871701
Abstract
Objective: To report our preliminary clinical experience in the antenatal
correction of open spina bifida using a fetoscopic approach and a
simplified closure technique. Methods: Four fetuses with lumbar-sacral
defects were operated in utero from 25 to 27 weeks. Surgeries were
performed percutaneously under general anesthesia using three trocars
and partial carbon dioxide insufflation. After dissection of the neural
placode, the surrounding skin was closed over a cellulose patch using a
single continuous stitch. Results: Surgical closure was successful in three
of the 4 cases. All successful cases showed improvement of the hindbrain
herniation and no neurosurgical repair was required in two cases. Delivery
occurred between 31 to 33 weeks, and no fetal or neonatal deaths occurred. Ventriculoperitoneal shunting
was not needed in 2/3 successful cases. Conclusions: Our preliminary experience suggests that definitive
fetoscopic repair of open spina bifida is feasible using our innovative surgical technique. A phase I trial for the
fetoscopic correction of OSB with this technique is currently being conducted.
J Matern Fetal Neonatal Med Downloaded from informahealthcare.com by 189.120.136.145 on 12/04/13
For personal use only.