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Related Experiment Video

Updated: Oct 21, 2025

Author Spotlight: Recent Advancements in Reoperative Foregut Surgery
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Complex gastroschisis: a new indication for fetal surgery?

L Joyeux1,2,3,4,5, M A Belfort5,6,7, P De Coppi1,2,3,8

  • 1MyFetUZ Fetal Research Center, Department of Development and Regeneration, Biomedical Sciences, KU Leuven, Leuven, Belgium.

Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology
|September 1, 2021
PubMed
Summary

Gastroschisis (GS) is a congenital defect where bowels exit the abdomen. Fetoscopic repair may improve outcomes for complex cases by addressing fetal bowel damage before birth.

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Area of Science:

  • Fetal Medicine
  • Neonatal Surgery
  • Congenital Anomalies

Background:

  • Gastroschisis (GS) involves congenital abdominal wall defects with bowel evisceration.
  • Pathogenesis is hypothesized as a two-hit process: umbilical hernia rupture followed by secondary bowel injury.
  • Complex GS, involving intestinal atresia or necrosis, leads to significant neonatal morbidity and mortality.

Purpose of the Study:

  • To evaluate the potential for fetoscopic repair of complex gastroschisis.
  • To assess the feasibility of antenatal management based on International Fetal Medicine and Surgery Society (IFMSS) criteria.
  • To propose a research agenda for clinical implementation.

Main Methods:

  • Review of natural history and prenatal diagnostic advancements.
  • Assessment of fetoscopic surgery safety and efficacy in expert centers.
  • Evaluation of criteria for fetal surgery eligibility.

Main Results:

  • Fetoscopic repair may reduce fetal and neonatal complications associated with complex GS.
  • Recent advances support reconsidering antenatal management for complex GS.
  • IFMSS criteria may be applicable for selecting candidates for fetoscopic repair.

Conclusions:

  • Fetoscopic repair is a promising approach for complex gastroschisis.
  • Further research is needed to establish a pathway for clinical implementation.
  • Antenatal intervention could potentially improve outcomes for affected neonates.