Premium
Two new approaches in intrauterine tracheal occlusion using an ultrathin fetoscope
Author(s) -
Tchirikov Michael,
Gatopoulos Georgios,
Strohner Miriam,
Puhl Alexander,
Steetskamp Joscha
Publication year - 2010
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.20687
Subject(s) - fetoscopy , medicine , balloon , occlusion , surgery , congenital diaphragmatic hernia , diaphragmatic hernia , complication , diaphragmatic breathing , hernia , pregnancy , fetus , prenatal diagnosis , genetics , alternative medicine , pathology , biology
Objectives/Hypothesis: To introduce and establish a new approach in minimal invasive fetoscopic surgery in order to reduce access trauma and the iatrogenic preterm premature rupture of the membranes (PPROM) as a major complication of intrauterine treatment of congenital diaphragmatic hernia. Methods: In total, 27 pregnant sheep were operated on using fetoscopes with 1.2 and 1.0 mm optics. We used an elliptic sheath alone with a maximum diameter of 2.6/1.3 mm; in these cases the balloon was placed under ultrasound control. In comparison, we placed the balloon under fetoscopic control using the fetoscopic sheath and a 7F (2.3 mm) introducer. Therefore, the maximum access trauma was not bigger than the diameter of sheath of introducer. Results: With this technique we successfully operated on 22 sheep. The use of real time three‐dimensional ultrasound control distinctly facilitates the operation procedure. Conclusions: Our preliminary findings show that fetoscopic tracheal occlusion using ultrathin fetoscopes and reducing the access trauma on the level of 4.2 or even 2.65 mm 2 could be seen as a method of reducing the rate of PPROM. Laryngoscope, 2010