Fetal surgery for spina bifida: a great success story in surgical innovation

2021 ◽  
Author(s):  
Luc Joyeux ◽  
Michael A Belfort
Keyword(s):  
Spina Bifida ◽  
Fetal Surgery ◽  
Great Success ◽  
Success Story ◽  
Surgical Innovation

scholarly journals ‘We did everything we could’– A qualitative study exploring the acceptability of maternal‐fetal surgery for spina bifida to parents

2021 ◽  
Author(s):  
Neeltje Crombag ◽  
Adalina Sacco ◽  
Bernadette Stocks ◽  
Philippe De Vloo ◽  
Johannes Van Der Merwe ◽  
...  
Keyword(s):  
Spina Bifida ◽  
Qualitative Study ◽  
Fetal Surgery

scholarly journals VP51.04: Options for intrauterine correction of spina bifida by open and fetoscopic fetal surgery: a systematic review

2021 ◽  
Vol 58 (S1) ◽  
pp. 306-306
Author(s):  
L. Lara‐Ávila ◽  
M. Martinez‐Rodriguez ◽  
R. Villalobos‐Gómez ◽  
H. López‐Briones ◽  
R. Cruz‐Martinez
Keyword(s):  
Systematic Review ◽  
Spina Bifida ◽  
Fetal Surgery

scholarly journals Fetal Surgery for Spina Bifida

2016 ◽  
pp. 548-554
Keyword(s):  
Spina Bifida ◽  
Fetal Surgery

scholarly journals Open Spina Bifida: Why Not Fetal Surgery?

2018 ◽  
Vol 45 (6) ◽  
pp. 430-434 ◽  
Author(s):  
Luca Mazzone ◽  
Ueli Moehrlen ◽  
Barbara Casanova ◽  
Samira Ryf ◽  
Nicole Ochsenbein-Kölble ◽  
...  
Keyword(s):  
Spina Bifida ◽  
Fetal Surgery ◽  
Open Spina Bifida

scholarly journals Fetal surgery for spina bifida aperta

2018 ◽  
Vol 103 (6) ◽  
pp. F589-F595 ◽  
Author(s):  
Luc Joyeux ◽  
Enrico Danzer ◽  
Alan W Flake ◽  
Jan Deprest
Keyword(s):  
Spina Bifida ◽  
Prolonged Exposure ◽  
Controlled Trial ◽  
Fetal Surgery ◽  
Neurological Deficits ◽  
Cerebrospinal Fluid Leakage ◽  
Essential Information ◽  
Ventriculoperitoneal Shunting ◽  
Spina Bifida Aperta ◽  
Randomised Controlled

Spina bifida aperta (SBA) is one of the most common congenital malformations. It can cause severe lifelong physical and neurodevelopmental disabilities. Experimental and clinical studies have shown that the neurological deficits associated with SBA are not simply caused by incomplete neurulation at the level of the lesion. Additional damage is caused by prolonged exposure of the spinal cord and nerves to the intrauterine environment and a suction gradient due to cerebrospinal fluid leakage, leading to progressive downward displacement of the hindbrain. This natural history can be reversed by prenatal repair. A randomised controlled trial demonstrated that mid-gestational maternal-fetal surgery for SBA decreases the need for ventriculoperitoneal shunting and hindbrain herniation at 12 months and improves neurological motor function at 30 months of age. This came at the price of maternal and fetal risks, the most relevant ones being increased prematurity and a persistent uterine corporeal scar. Recently minimally invasive fetal approaches have been introduced clinically yet they lack extensive experimental or clinical trials. We aim to provide clinicians with the essential information necessary to counsel SBA parents as the basis for considering referral of selected patients to expert fetal surgery centres. We review the reported clinical outcomes and discuss recent developments of potentially less invasive fetal SBA approaches.

Fetal surgery for spina bifida

The Lancet ◽  
1999 ◽  
Vol 353 (9150) ◽  
pp. 406 ◽  
Author(s):  
Gary Magram
Keyword(s):  
Spina Bifida ◽  
Fetal Surgery

scholarly journals EP21.02: Intrauterine open fetal surgery for cervical spina bifida correction: case report

2017 ◽  
Vol 50 ◽  
pp. 357-357
Author(s):  
S. Sarmento ◽  
H.J. Milani ◽  
M.M. Barbosa ◽  
S. Cavalheiro ◽  
I. Suriano ◽  
...  
Keyword(s):  
Case Report ◽  
Spina Bifida ◽  
Fetal Surgery

Retrieving the Moral in the Ethics of Maternal-Fetal Surgery

2020 ◽  
Vol 29 (3) ◽  
pp. 480-493
Author(s):  
VIRGINIA L. BARTLETT ◽  
MARK J. BLITON
Keyword(s):  
Spina Bifida ◽  
Pregnant Women ◽  
Fetal Surgery ◽  
Self Reflection ◽  
Uterine Surgery ◽  
Early Experiences ◽  
Clinical Ethics Consultants ◽  
Vanderbilt University ◽  
Do So ◽  
Open Uterine

Open-uterine surgery to repair spina bifida, or ‘fetal surgery of open neural tube defects,’ has generated questions throughout its history—and continues to do so in a variety of contexts. As clinical ethics consultants who worked (Mark J. Bliton) and trained (Virginia L. Bartlett) at Vanderbilt University—where the first successful cases of open-uterine repair of spina bifida were carried out—we lived with these questions for nearly two decades. We worked with clinicians as they were developing and offering the procedure, with researchers in refining and studying the procedure, and with pregnant women and their partners as they considered whether to undergo the procedure. From this experience in the early studies at Vanderbilt, we learned that pregnant women and their partners approach the clinical uncertainty of such a risky procedure with a curious and unique combination of practicality, self-reflection, fear, and overwhelming hope. These early experiences were a major contributing factor to the inclusion of an ethics-focused interview in the informed consent process for the Management of Myelomeningocele Study (MOMS) trial study design.

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