{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T08:43:48Z","timestamp":1769503428472,"version":"3.49.0"},"reference-count":31,"publisher":"S. Karger AG","issue":"9-10","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Fetal Diagn Ther"],"published-print":{"date-parts":[[2022]]},"abstract":"<jats:p>Background: Given the maternal morbidity of open fetal surgery, the development of prenatal fetoscopic repair for spina bifida aperta (SBA) is encouraged. Objective: We hereby report the early results from our center, using a laparotomy-assisted CO2-fetoscopic approach. Methods: This study was conducted in patients with an SBA &lt; T1 and &gt;S1, &lt;26 weeks of gestation, with Chiari II. Fetoscopic repair was performed using 2 operating trocars in the uterus exteriorized through a transverse laparotomy. Endoscopy was performed under humidified and heated CO2 insufflation. Following dissection of the lesion, a 1-layer approach was performed with a muscle\/skin flap sutured over a patch of Duragen. Main outcomes were watertight repair at birth and the need for postnatal neurosurgical surgery including shunting within 6 months. Results: Of 87 women assessed for prenatal therapy, 7 were included. Surgery was performed at 24 (23\u201326) weeks\u2019 gestation. There was no fetal demise. Conversion to hysterotomy was not performed, although surgery could not be performed in 1 case because of fetal position. Severe preeclampsia developed postoperatively in 1 case. In the other 6 cases, follow-up was uneventful except for premature rupture membranes which occurred in 3\/6 cases at 30, 34, and 36+5 weeks\u2019 gestation. Gestational age at delivery was 32 + 5 (31\u221236 + 5) weeks\u2019 gestation. Repair was watertight at birth except in 2 cases which required complementary postnatal surgical repair. Reverse hindbrain herniation during pregnancy was observed in 4\/6 cases. In 3\/6 cases, shunting was necessary within 6 months after birth. At 12 months, a functional gain of \u22652 metameric levels was observed in 3 cases of the 6 survivors. Conclusion: Laparotomy-assisted fetoscopic repair is a reasonable option for women who choose and are eligible for antenatal surgery, both in terms of maternal and perinatal morbidity. <\/jats:p>","DOI":"10.1159\/000525552","type":"journal-article","created":{"date-parts":[[2022,8,31]],"date-time":"2022-08-31T21:00:31Z","timestamp":1661979631000},"page":"377-384","source":"Crossref","is-referenced-by-count":9,"title":["Laparotomy-Assisted 2-Port Fetoscopic Repair of Spina Bifida Aperta: Report of a Single-Center Experience in Paris, 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