Endoscopic tracheal obstruction with an expanding device in a fetal lamb model: preliminary considerations

Tracheal obstruction to promote lung growth may be a less aggressive alternative to open fetal surgery in the antenatal treatment of congenital diaphragmatic hernia. Herein, we explore the feasibility of placing an occluding device through fetal tracheoscopy. A self-expanding umbrella allowed adequate sealing of the tracheal lumen even as the tracheal diameter more than doubled between 110 and 138 days of gestation (term = 145 days) in a sheep model. Distal intratracheal pressures after umbrella placement, and lung weight at delivery, were comparable to those after formal tracheal ligation.