Two new approaches in intrauterine tracheal occlusion using an ultrathin fetoscope
Article first published online: 30 NOV 2009
Copyright © 2009 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 120, Issue 2, pages 394–398, February 2010
How to Cite
Tchirikov, M., Gatopoulos, G., Strohner, M., Puhl, A. and Steetskamp, J. (2010), Two new approaches in intrauterine tracheal occlusion using an ultrathin fetoscope. The Laryngoscope, 120: 394–398. doi: 10.1002/lary.20687
- Issue published online: 20 JAN 2010
- Article first published online: 30 NOV 2009
- Manuscript Accepted: 21 JUL 2009
- Manuscript Revised: 18 JUN 2009
- Manuscript Received: 6 MAY 2009
- Tracheal occlusion;
- lung hypoplasia;
- congenital diaphragmatic hernia;
- preterm premature rupture of the membranes
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.
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.
With this technique we successfully operated on 22 sheep. The use of real time three-dimensional ultrasound control distinctly facilitates the operation procedure.
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 mm2 could be seen as a method of reducing the rate of PPROM. Laryngoscope, 2010