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Minimally Invasive Bimanual Fetal Surgery—A Review

Background: The aim of this review is to discuss experimental and clinical techniques and interventions of fetal surgery which have been performed minimally invasively by the means of a three-port approach for the fetoscope and instruments for the left and right hand of the surgeon (bimanual minimal...

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Autores principales: Brunner, Susanne Eva, Durmaz, Lidya-Olgu, Meinzer, Andreas, Arp, Milena, Krebs, Thomas Franz, Bergholz, Robert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9498043/
https://www.ncbi.nlm.nih.gov/pubmed/36138686
http://dx.doi.org/10.3390/children9091377
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author Brunner, Susanne Eva
Durmaz, Lidya-Olgu
Meinzer, Andreas
Arp, Milena
Krebs, Thomas Franz
Bergholz, Robert
author_facet Brunner, Susanne Eva
Durmaz, Lidya-Olgu
Meinzer, Andreas
Arp, Milena
Krebs, Thomas Franz
Bergholz, Robert
author_sort Brunner, Susanne Eva
collection PubMed
description Background: The aim of this review is to discuss experimental and clinical techniques and interventions of fetal surgery which have been performed minimally invasively by the means of a three-port approach for the fetoscope and instruments for the left and right hand of the surgeon (bimanual minimally invasive fetal surgery). Methods: a print and electronic literature search was performed; the titles and abstracts were screened and included reports were reviewed in a two-step approach. First, reports other than minimally invasive fetal surgery were excluded, then a full text review and analysis of the reported data was performed. Results: 17 reports were included. The heterogeneity of the included reports was high. Although reports on human fetoscopic surgical procedures can be found, most of them do not pick out bimanual fetal surgery as a central theme but rather address interventions applying a fetoscope with a working channel for a laser fiber, needle or flexible instrument. Most reports were on experimentation in animal models, the human application of minimally invasive fetoscopic bimanual surgery is rare and has at best been explored for the prenatal treatment of spina bifida. Some reported bimanual fetoscopic procedures were performed on the exteriorized uterus via a maternal laparotomy and can therefore not be classified as being truly minimally invasive. Discussion: our results demonstrate that minimally invasive fetoscopic bimanual surgery is rare, even in animal models, excluding many other techniques and procedures that are loosely termed ‘minimally invasive fetal surgery’ which we suggest to better label as ‘interventions’. Thus, more research on percutaneous minimally invasive bimanual fetoscopic surgery is warranted, with the aim to reduce the maternal, uterine and fetal trauma for correction of congenital malformations.
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spelling pubmed-94980432022-09-23 Minimally Invasive Bimanual Fetal Surgery—A Review Brunner, Susanne Eva Durmaz, Lidya-Olgu Meinzer, Andreas Arp, Milena Krebs, Thomas Franz Bergholz, Robert Children (Basel) Review Background: The aim of this review is to discuss experimental and clinical techniques and interventions of fetal surgery which have been performed minimally invasively by the means of a three-port approach for the fetoscope and instruments for the left and right hand of the surgeon (bimanual minimally invasive fetal surgery). Methods: a print and electronic literature search was performed; the titles and abstracts were screened and included reports were reviewed in a two-step approach. First, reports other than minimally invasive fetal surgery were excluded, then a full text review and analysis of the reported data was performed. Results: 17 reports were included. The heterogeneity of the included reports was high. Although reports on human fetoscopic surgical procedures can be found, most of them do not pick out bimanual fetal surgery as a central theme but rather address interventions applying a fetoscope with a working channel for a laser fiber, needle or flexible instrument. Most reports were on experimentation in animal models, the human application of minimally invasive fetoscopic bimanual surgery is rare and has at best been explored for the prenatal treatment of spina bifida. Some reported bimanual fetoscopic procedures were performed on the exteriorized uterus via a maternal laparotomy and can therefore not be classified as being truly minimally invasive. Discussion: our results demonstrate that minimally invasive fetoscopic bimanual surgery is rare, even in animal models, excluding many other techniques and procedures that are loosely termed ‘minimally invasive fetal surgery’ which we suggest to better label as ‘interventions’. Thus, more research on percutaneous minimally invasive bimanual fetoscopic surgery is warranted, with the aim to reduce the maternal, uterine and fetal trauma for correction of congenital malformations. MDPI 2022-09-13 /pmc/articles/PMC9498043/ /pubmed/36138686 http://dx.doi.org/10.3390/children9091377 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Brunner, Susanne Eva
Durmaz, Lidya-Olgu
Meinzer, Andreas
Arp, Milena
Krebs, Thomas Franz
Bergholz, Robert
Minimally Invasive Bimanual Fetal Surgery—A Review
title Minimally Invasive Bimanual Fetal Surgery—A Review
title_full Minimally Invasive Bimanual Fetal Surgery—A Review
title_fullStr Minimally Invasive Bimanual Fetal Surgery—A Review
title_full_unstemmed Minimally Invasive Bimanual Fetal Surgery—A Review
title_short Minimally Invasive Bimanual Fetal Surgery—A Review
title_sort minimally invasive bimanual fetal surgery—a review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9498043/
https://www.ncbi.nlm.nih.gov/pubmed/36138686
http://dx.doi.org/10.3390/children9091377
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