Category: Open Spina Bifida

Percutaneous mini-laparotomy fetoscopic treatment of Open Spina Bifida

Percutaneous mini-laparotomy fetoscopic treatment of Open Spina Bifida

Open spina bifida develops when the spine fails to close at some point along its length during fetal development.

Our group has worked on developing a minimally-invasive technique (so-called ‘keyhole surgery’) for the antenatal treatment of MMC, translating an experience of more than 10 years in the animal model to a viable clinical application. The technique does not require a hysterotomy (uterine incision). Instead, small instruments are placed into the womb through tiny incisions, and with the use of partial CO2 insufflation, the open spina bifida is repaired. This approach minimizes the risks of the surgery for the mother while preserving the potential benefits of the in-utero repair for the fetus.

Doctors at The Fetal Institute, Miami are conducting a clinical trial on the fetoscopic repair of open spina bifida

Doctors at The Fetal Institute, Miami are conducting a clinical trial on the fetoscopic repair of open spina bifida

Open spina bifida (OSB), a birth defect that occurs in approximately 1 in 1,500 births in the United States, results from failure of the spine to close at some point along its length during fetal development. The defect leads to injury and loss of spinal cord tissue at and below the defect. Research showed that antenatal treatment of OSB via open fetal surgery, which requires opening the maternal abdomen and uterus, can improve the outcome of babies affected with OSB. However, the mother is at risk for rupture of the uterus (uterine rupture) and requires delivery by cesarean section for the affected pregnancy and for any subsequent pregnancy.

Doctors at The Fetal Institute, Miami and the USFetus, in collaboration with colleagues in Brazil, have developed a minimally-invasive (fetoscopic) technique to treat fetuses with OSB, which does not require opening the uterus. This allows the mother to deliver vaginally and avoid the risk of uterine rupture. The doctors are currently conducting a clinical trial to validate this new fetoscopic technique. For further information, please click here.