Intrauterine endoscopic creation of urinary tract obstruction in the fetal lamb: A model for fetal surgery

doi:10.1016/0002-9378(95)90472-7

American Journal of Obstetrics and Gynecology

Volume 172, Issue 5, May 1995, Pages 1422-1426

https://doi.org/10.1016/0002-9378(95)90472-7 Get rights and content

Abstract

OBJECTIVE: Our purpose was to evaluate the feasibility of intrauterine endoscopic fetal surgery in a fetal lamb model by creating a urinary tract obstruction.

STUDY DESIGN: Lower urinary tract obstruction was created by ligation of the urethra and urachus in 21 fetal lambs, eight at 95 to 105 days' gestation (term 145 days) and 13 at 70 to 75 days. The endoscopic approach consisted of a 0-degree 5 mm telescope, three 5 mm cannulas, uterine distention by amnioinfusion, and adapted instrumentation. Intrauterine fetal monitoring included temperature and pulse oximetry registration.

RESULTS: In 20 cases the urachus could be identified and ligated inside the umbilical cord. The urethra was ligated in the anterior abdominal wall (n = 7) obstructed at the level of the penis (n = 13). Mean fetal heart rate was 147 ± 35 beats/min, and fetal temperature at the end of intervention was 38.14° ± 2.1° C. The overall postoperative survival rate was 76%.

CONCLUSION: Urinary tract obstruction can be created endoscopically in the fetal lamb. This operation can serve as a model for endoscopic fetal surgery.

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^☆: Supported in part by Belgium Council for Scientific Research NFWO grant No. 3.0122.94. F.I.L. is recipient of a doctoral scholarship from the Research Council of the Katholieke Universiteit Leuven, and J.A.D. and K.H.E.P. are recipients of research fellowships from the Faculty of Medicine of the Katholieke Universiteit Leuven.

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General obstetrics and gynecologyIntrauterine endoscopic creation of urinary tract obstruction in the fetal lamb: A model for fetal surgery☆

Abstract

Obstet Gynecol Clin North Am

J Pediatr Surg

J Pediatr Surg

Ann Fr Anesth Reamin

J Pediatr Surg

Am J Obstet Gynecol

J Pediatr Surg

The fetus as a patient

La chirurgie foetale: pour quoi faire?

Pediatrie

Embryoscopy: a closer look at first-trimester diagnosis and treatment

Am J Obstet Gynecol

Fetoscopy guided by real-time ultrasound for pure fetal blood samples, fetal skin samples and examination of the fetus in utero

Br J Obstet Gynaecol

General obstetrics and gynecology
Intrauterine endoscopic creation of urinary tract obstruction in the fetal lamb: A model for fetal surgery☆