Modification of the gasless fetoscopy technique for the treatment of large myelomeningocele: a study in sheep
Autor(a) principal: | |
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Data de Publicação: | 2010 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Einstein (São Paulo) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082010000100018 |
Resumo: | ABSTRACT Objective: To change the gasless fetoscopy technique in order to reduce the diameter of entry orifices in the myometrium. Methods: Seven pregnant ewes were submitted to fetoscopy for repairing a large skin defect measuring 4.0 × 3.0 cm, created in the fetal lumbar region at the gestational age of 100 days. The defect was repaired through continuous suture of the skin with approximation of borders. Gasless fetoscopy was used for performing the suture with three orifices to allow entry of the trocar into the myometrium. A 5.0-mm optical trocar, and 3.5-mm grasping, dissecting and suturing forceps were used. After surgery, pregnancy was maintained until the animals were euthanized on the 133rd day of gestation, and the fetuses were evaluated. Results: Seven pregnant ewes underwent surgery; the first two cases were characterized as the Pilot Group, in which the endoscopic technique was modified and caliber reduction was possible in two out of three entry orifices in the myometrium. In the five remaining cases (Study Group), the repair was successfully carried out in all the fetuses, and the mean duration of fetoscopy was 98 minutes. There was a case of maternal death attributed to intrauterine infection. Mean intrauterine permanence after surgery was 12 days. Conclusions: The technique was successfully modified, allowing reduction of the uterine orifices necessary to perform the repair of a skin defect in the fetal lumbar region through a new fetoscopy technique. The impact of this modification in repair of myelomeningocele in human fetuses should be studied. |
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Modification of the gasless fetoscopy technique for the treatment of large myelomeningocele: a study in sheepFetoscopy/methodsFetal therapies/methodsMeningomyelocele/surgerySheep/abnormalitiesDisease models, animalSurgical procedures, operativeSuture techniquesUltrasonographyVideo-assisted surgeryABSTRACT Objective: To change the gasless fetoscopy technique in order to reduce the diameter of entry orifices in the myometrium. Methods: Seven pregnant ewes were submitted to fetoscopy for repairing a large skin defect measuring 4.0 × 3.0 cm, created in the fetal lumbar region at the gestational age of 100 days. The defect was repaired through continuous suture of the skin with approximation of borders. Gasless fetoscopy was used for performing the suture with three orifices to allow entry of the trocar into the myometrium. A 5.0-mm optical trocar, and 3.5-mm grasping, dissecting and suturing forceps were used. After surgery, pregnancy was maintained until the animals were euthanized on the 133rd day of gestation, and the fetuses were evaluated. Results: Seven pregnant ewes underwent surgery; the first two cases were characterized as the Pilot Group, in which the endoscopic technique was modified and caliber reduction was possible in two out of three entry orifices in the myometrium. In the five remaining cases (Study Group), the repair was successfully carried out in all the fetuses, and the mean duration of fetoscopy was 98 minutes. There was a case of maternal death attributed to intrauterine infection. Mean intrauterine permanence after surgery was 12 days. Conclusions: The technique was successfully modified, allowing reduction of the uterine orifices necessary to perform the repair of a skin defect in the fetal lumbar region through a new fetoscopy technique. The impact of this modification in repair of myelomeningocele in human fetuses should be studied.Instituto Israelita de Ensino e Pesquisa Albert Einstein2010-03-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082010000100018einstein (São Paulo) v.8 n.1 2010reponame:Einstein (São Paulo)instname:Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEPAE)instacron:IIEPAE10.1590/s1679-45082010ao1440info:eu-repo/semantics/openAccessPedreira,Denise Araujo LapaAcácio,Gregório LorenzoAbou-Jamra,Rogério ChaccurOliveira,Rita de Cássia SanchesCaldini,Elia GarciaSaldiva,Paulo Hilário Nascimentoeng2017-03-14T00:00:00Zoai:scielo:S1679-45082010000100018Revistahttps://journal.einstein.br/pt-br/ONGhttps://old.scielo.br/oai/scielo-oai.php||revista@einstein.br2317-63851679-4508opendoar:2017-03-14T00:00Einstein (São Paulo) - Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEPAE)false |
dc.title.none.fl_str_mv |
Modification of the gasless fetoscopy technique for the treatment of large myelomeningocele: a study in sheep |
title |
Modification of the gasless fetoscopy technique for the treatment of large myelomeningocele: a study in sheep |
spellingShingle |
Modification of the gasless fetoscopy technique for the treatment of large myelomeningocele: a study in sheep Pedreira,Denise Araujo Lapa Fetoscopy/methods Fetal therapies/methods Meningomyelocele/surgery Sheep/abnormalities Disease models, animal Surgical procedures, operative Suture techniques Ultrasonography Video-assisted surgery |
title_short |
Modification of the gasless fetoscopy technique for the treatment of large myelomeningocele: a study in sheep |
title_full |
Modification of the gasless fetoscopy technique for the treatment of large myelomeningocele: a study in sheep |
title_fullStr |
Modification of the gasless fetoscopy technique for the treatment of large myelomeningocele: a study in sheep |
title_full_unstemmed |
Modification of the gasless fetoscopy technique for the treatment of large myelomeningocele: a study in sheep |
title_sort |
Modification of the gasless fetoscopy technique for the treatment of large myelomeningocele: a study in sheep |
author |
Pedreira,Denise Araujo Lapa |
author_facet |
Pedreira,Denise Araujo Lapa Acácio,Gregório Lorenzo Abou-Jamra,Rogério Chaccur Oliveira,Rita de Cássia Sanches Caldini,Elia Garcia Saldiva,Paulo Hilário Nascimento |
author_role |
author |
author2 |
Acácio,Gregório Lorenzo Abou-Jamra,Rogério Chaccur Oliveira,Rita de Cássia Sanches Caldini,Elia Garcia Saldiva,Paulo Hilário Nascimento |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Pedreira,Denise Araujo Lapa Acácio,Gregório Lorenzo Abou-Jamra,Rogério Chaccur Oliveira,Rita de Cássia Sanches Caldini,Elia Garcia Saldiva,Paulo Hilário Nascimento |
dc.subject.por.fl_str_mv |
Fetoscopy/methods Fetal therapies/methods Meningomyelocele/surgery Sheep/abnormalities Disease models, animal Surgical procedures, operative Suture techniques Ultrasonography Video-assisted surgery |
topic |
Fetoscopy/methods Fetal therapies/methods Meningomyelocele/surgery Sheep/abnormalities Disease models, animal Surgical procedures, operative Suture techniques Ultrasonography Video-assisted surgery |
description |
ABSTRACT Objective: To change the gasless fetoscopy technique in order to reduce the diameter of entry orifices in the myometrium. Methods: Seven pregnant ewes were submitted to fetoscopy for repairing a large skin defect measuring 4.0 × 3.0 cm, created in the fetal lumbar region at the gestational age of 100 days. The defect was repaired through continuous suture of the skin with approximation of borders. Gasless fetoscopy was used for performing the suture with three orifices to allow entry of the trocar into the myometrium. A 5.0-mm optical trocar, and 3.5-mm grasping, dissecting and suturing forceps were used. After surgery, pregnancy was maintained until the animals were euthanized on the 133rd day of gestation, and the fetuses were evaluated. Results: Seven pregnant ewes underwent surgery; the first two cases were characterized as the Pilot Group, in which the endoscopic technique was modified and caliber reduction was possible in two out of three entry orifices in the myometrium. In the five remaining cases (Study Group), the repair was successfully carried out in all the fetuses, and the mean duration of fetoscopy was 98 minutes. There was a case of maternal death attributed to intrauterine infection. Mean intrauterine permanence after surgery was 12 days. Conclusions: The technique was successfully modified, allowing reduction of the uterine orifices necessary to perform the repair of a skin defect in the fetal lumbar region through a new fetoscopy technique. The impact of this modification in repair of myelomeningocele in human fetuses should be studied. |
publishDate |
2010 |
dc.date.none.fl_str_mv |
2010-03-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082010000100018 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082010000100018 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/s1679-45082010ao1440 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Instituto Israelita de Ensino e Pesquisa Albert Einstein |
publisher.none.fl_str_mv |
Instituto Israelita de Ensino e Pesquisa Albert Einstein |
dc.source.none.fl_str_mv |
einstein (São Paulo) v.8 n.1 2010 reponame:Einstein (São Paulo) instname:Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEPAE) instacron:IIEPAE |
instname_str |
Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEPAE) |
instacron_str |
IIEPAE |
institution |
IIEPAE |
reponame_str |
Einstein (São Paulo) |
collection |
Einstein (São Paulo) |
repository.name.fl_str_mv |
Einstein (São Paulo) - Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEPAE) |
repository.mail.fl_str_mv |
||revista@einstein.br |
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1752129905755160576 |