Fetoscopic Reduction and Closure for Complex Gastroschisis: A Novel Minimally Invasive Prenatal Approach

Area of Science:

• Fetal Medicine
• Minimally Invasive Surgery
• Neonatal Surgery

Background:

• Gastroschisis is a congenital defect involving fetal intestinal herniation through an abdominal wall opening.
• Current standard treatment involves postnatal surgical repair.
• Fetoscopic fetal surgery is an emerging intervention for complex cases.

Purpose of the Study:

• To document a fetoscopic technique for in utero gastroschisis correction.
• To evaluate the feasibility and safety of this minimally invasive approach.
• To report neonatal outcomes following in utero repair.

Main Methods:

• A case report detailing a fetoscopic gastroschisis repair at 29 weeks gestation.
• Ultrasound guidance was used to introduce a fetoscope and trocars into the amniotic cavity.
• Herniated intestines were repositioned, and the abdominal wall defect was closed using continuous suture.

Main Results:

• The procedure was completed in 80 minutes with continuous fetal vitality monitoring.
• A healthy female infant was delivered at 32 weeks gestation.
• The newborn exhibited normal gastrointestinal function and was discharged at 14 days without requiring additional surgery.

Conclusions:

• Fetoscopic repair of gastroschisis is feasible and safe, leading to favorable neonatal outcomes.
• This technique resulted in early discharge and avoidance of further surgical interventions.
• Further investigation via randomized clinical trials is warranted to compare this approach with standard postnatal treatment.