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Fetoscopic patch coverage of experimental myelomenigocele using a two-port access in fetal sheep.

Childs Nerv Syst

July 2017

Service de Médecine Foetale, Hôpital Armand Trousseau, APHP, 26 avenue du Docteur Arnold Netter, 75012, Paris, France.

Purpose: This study aims to assess the feasibility and the effectiveness of a fetoscopic myelomeningocele (MMC) coverage using a sealed inert patch through a two-port access, in the sheep model.

Methods: Forty-four fetuses underwent surgical creation of a MMC defect at day 75 and were divided into four groups according to the MMC repair technique, performed at day 90. Group 1 remained untreated.

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Objectives: The purpose of this prospective study was to identify selection criteria for immediate single-stage reconstruction in patients with severe complex craniofacial trauma to improve their functional outcome and reduce complications.

Patients And Methods: In this series, 24 new patients (16 men and 8 women) were added to our previous group (26 patients) with an age range from 10 to 55 years with mean of 26 years and Glasgow Coma Scale scores of 5-13; all patients had a combined single-stage repair of their complex craniofacial injuries within 6 h of their admission. We added some modifications to our standard technique using three-dimensional computed tomography, intracranial pressure monitoring, and support of dural repair/graft using dural patch and glue.

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A best evidence topic was written according to a structured protocol. The question addressed was whether conservative or surgical management would result in better outcomes in patients presenting with left ventricular free wall rupture (LVFWR) following acute myocardial infarction. Surgical techniques involved were infarctectomy + patch repair, suturing of an overlay patch to the defect, patch-and-glue repair and so on, on or off cardiopulmonary bypass.

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Single-Access Fetal Endoscopy (SAFE) for myelomeningocele in sheep model I: amniotic carbon dioxide gas approach.

Surg Endosc

October 2013

Fetal Surgery Program, Congenital Malformations Research Group, Research Institute of Hospital Universitari Vall d'Hebron, Edifici Infantil, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain,

Background: This study aimed to assess the feasibility of single-access fetal endoscopy (SAFE) for the management of myelomeningocele (MMC) using intrauterine carbon dioxide as a distension medium in a sheep model.

Methods: This prospective experimental case-control study investigated 12 lamb fetuses that had a myelomeningocele-like defect surgically created on the 75th day of gestation. Four fetuses remained untreated (control group), and eight fetuses had MMC repair using two fetoscopic approaches with carbon dioxide used to distend the amniotic cavity.

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