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The technique of fetal endoscopic tracheal occlusion (FETO) was developed to totally occlude the fetal trachea using an intratracheal balloon in the treatment of congenital diaphragmatic hernia with lung hypoplasia. To improve this approach, we developed a method for non-contact, rapid destruction of the balloon using high intensity focused ultrasound (HIFU), a speci c balloon injection uid, and euthanized rabbits (1 kg). In an initial experiment (5 rabbits), we in ated an intratracheal balloon by injecting in 1.0 ml of uid and demonstrated that HIFU could successfully burst the balloon in all cases, although the tracheal membranous portion and the skin overlying the trachea were injured in 4 and 2 cases, respectively. In our second experiment (6 animals), we in ated the balloon using only 0.5-0.6 ml of fluid. In all cases, HIFU either burst (1 animal) or deflated (5 animals) the balloon and there was substantially decreased injury of the tracheal membranous portion (2 cases) or overlying skin (2 cases). The total HIFU energy output revealed no signi cant difference between the rst and second experimental groups. In conclusion, the intratracheal balloon placed by FETO can be removed using HIFU alone.

Non-touch, Quick Destruction of the Tracheal Occluding Balloon Using HIFU