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首页> 外文期刊>Einstein (So Paulo) >Modification of the gasless fetoscopy technique for the treatment of large myelomeningocele: a study in sheep
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Modification of the gasless fetoscopy technique for the treatment of large myelomeningocele: a study in sheep

机译：改良无气胎儿镜技术治疗大型脊髓膜膨出症的研究：在绵羊中的研究

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ABSTRACTObjective: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.
机译：摘要目的：改变无气胎儿镜检查技术，以减少子宫内膜进入口的直径。方法：将7头怀孕的母羊送交胎儿镜检查，以修复在胎儿腰椎区域形成的4.0×3.0 cm大皮肤缺损。胎龄为100天。通过连续缝合皮肤（接近边界）修复了缺损。无气腹腔镜被用于通过三个孔口进行缝合，以使套管针进入子宫肌层。使用5.0毫米光学套管针和3.5毫米抓握，解剖和缝合钳。手术后，维持妊娠直到妊娠第133天使动物安乐死并评估胎儿。结果：七只怀孕的母羊接受了手术;前两个病例的特征是先导组，其中对内窥镜技术进行了修改，并且有可能在子宫内膜的三个进入孔中的两个进入孔中减小口径。在剩下的五个病例（研究组）中，所有胎儿均成功进行了修复，并且胎儿镜检查的平均持续时间为98分钟。有一例死于子宫内感染的产妇死亡。手术后的平均子宫内手术持续时间为12天。结论：该技术已成功改进，可通过一种新的胎儿镜检查技术减少子宫孔，以修复胎儿腰椎区域的皮肤缺损。应该研究这种修饰对人类胎儿髓鞘膜膨出的修复的影响。

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