Implementation and Assessment of a Laparotomy-Assisted Three-Port Fetoscopic Spina Bifida Repair Program

Area of Science:

• Medical Science
• Surgical Innovation
• Fetal Medicine

Background:

• Open spina bifida (OSB) is a congenital condition requiring specialized prenatal care.
• Fetal therapy for OSB has evolved, with fetoscopic repair techniques emerging.
• Laparotomy-assisted fetoscopic repair represents a modification of existing prenatal surgical approaches.

Purpose of the Study:

• To report the successful implementation of a three-port, three-layer fetoscopic repair of OSB.
• To demonstrate the transferability of a previously described surgical technique to a new center.
• To highlight the importance of interdisciplinary preparation and experienced guidance in adopting advanced fetal surgery.

Main Methods:

• A two-year preparation period involving multidisciplinary team training.
• Implementation of a three-port, three-layer fetoscopic repair technique via laparotomy assistance.
• Application of the technique at the University Medical Center Giessen and Marburg (UKGM).

Main Results:

• The UKGM team became the first in the German-speaking region to perform this specific fetoscopic OSB repair.
• The successful transfer and application of the technique were achieved.
• The study underscores the feasibility of adopting advanced fetal surgical procedures in new settings.

Conclusions:

• Advanced fetal surgical techniques for open spina bifida can be successfully transferred to new centers.
• Intensive multidisciplinary preparation and guidance from experienced teams are crucial for successful adoption.
• This achievement expands access to innovative prenatal treatments for OSB in the German-speaking area.