Implementation and Assessment of a Laparotomy-Assisted Three-Port Fetoscopic Spina Bifida Repair Program
Corinna Keil1, Siegmund Köhler1, Benjamin Sass2
1Department of Prenatal Medicine and Fetal Therapy, Philipps University, 35043 Marburg, Germany.
Insights
Fetal surgery for open spina bifida (OSB) is advancing. A German center successfully adapted a laparotomy-assisted fetoscopic repair technique, demonstrating successful transferability with proper training and preparation.
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.
Abstract:
Open spina bifida (OSB) is a congenital, non-lethal malformation with multifactorial etiology. Fetal therapy can be offered under certain conditions to parents after accurate prenatal diagnostic and interdisciplinary counseling. Since the advent of prenatal OSB surgery, various modifications of the original surgical techniques have evolved, including laparotomy-assisted fetoscopic repair. After a two-year preparation time, the team at the University of Giessen and Marburg (UKGM) became the first center to provide a three-port, three-layer fetoscopic repair of OSB via a laparotomy-assisted approach in the German-speaking area. We point out that under the guidance of experienced centers and by intensive multidisciplinary preparation and training, a previously described and applied technique could be transferred to a different setting.
