The combined method: A novel access technique for fetal endoscopic surgery

Tatsuo Kuroda, Morihiro Saeki, Kiyoshi Tanaka, Makoto Komura, Toshiro Honna, Miwako Nakano, Masahiko Sugiyama, Satoshi Nakagawa, Katsuyuki Miyasaka

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background/Purpose: To develop practical and less invasive techniques for fetal endoscopic surgery, new methods of lifting the uterine wall to allow fetal surgery without maternal laparotomy were developed and assessed. Methods: Fetal endoscopic surgical procedures, including tracheostomy and umbilical vascular cannulation, were performed using one of the three methods to enter the uterus without maternal laparotomy in pregnant goats (n = 6; 105 to 115 days' gestation): (1) direct uterine lifting with an air-cushion device; (2) indirect uterine lifting, in which the uterine wall was fixed to the maternal abdominal wall using balloon tip ports inserted percutaneously by Seldinger's method, then the maternal abdomen was lifted mechanically; and (3) combined method, in which low pressure CO2 (5 mm Hg for initial inflation and 2 mm Hg for maintenance) was insufflated into the uterus in addition to the indirect uterine lifting cited above. Results: The direct uterine lifting caused massive injury of myometrium and uterine membranes. The creation of intrauterine space and the protection of the membranes were not accomplished effectively by the indirect uterine lifting only. The combined method provided the adequate intrauterine space and excellent endoscopic visibility for completion of the endoscopic procedures with minimal uterine injury. Conclusion: The fetal endoscopic surgery may be accomplished simply and safely by the combined method, a novel technique of uterine lifting to allow fetal surgery without maternal laparotomy.

Original languageEnglish
Pages (from-to)1641-1644
Number of pages4
JournalJournal of Pediatric Surgery
Volume33
Issue number11
Publication statusPublished - 1998 Nov
Externally publishedYes

Fingerprint

Mothers
Laparotomy
Uterus
Umbilicus
Membranes
Myometrium
Tracheostomy
Economic Inflation
Wounds and Injuries
Abdominal Wall
Goats
Catheterization
Abdomen
Endoscopy
Blood Vessels
Air
Maintenance
Pressure
Equipment and Supplies
Pregnancy

Keywords

  • Fetal endoscopic surgery
  • Gasless laparoscopic method

ASJC Scopus subject areas

  • Surgery

Cite this

Kuroda, T., Saeki, M., Tanaka, K., Komura, M., Honna, T., Nakano, M., ... Miyasaka, K. (1998). The combined method: A novel access technique for fetal endoscopic surgery. Journal of Pediatric Surgery, 33(11), 1641-1644.

The combined method : A novel access technique for fetal endoscopic surgery. / Kuroda, Tatsuo; Saeki, Morihiro; Tanaka, Kiyoshi; Komura, Makoto; Honna, Toshiro; Nakano, Miwako; Sugiyama, Masahiko; Nakagawa, Satoshi; Miyasaka, Katsuyuki.

In: Journal of Pediatric Surgery, Vol. 33, No. 11, 11.1998, p. 1641-1644.

Research output: Contribution to journalArticle

Kuroda, T, Saeki, M, Tanaka, K, Komura, M, Honna, T, Nakano, M, Sugiyama, M, Nakagawa, S & Miyasaka, K 1998, 'The combined method: A novel access technique for fetal endoscopic surgery', Journal of Pediatric Surgery, vol. 33, no. 11, pp. 1641-1644.
Kuroda T, Saeki M, Tanaka K, Komura M, Honna T, Nakano M et al. The combined method: A novel access technique for fetal endoscopic surgery. Journal of Pediatric Surgery. 1998 Nov;33(11):1641-1644.
Kuroda, Tatsuo ; Saeki, Morihiro ; Tanaka, Kiyoshi ; Komura, Makoto ; Honna, Toshiro ; Nakano, Miwako ; Sugiyama, Masahiko ; Nakagawa, Satoshi ; Miyasaka, Katsuyuki. / The combined method : A novel access technique for fetal endoscopic surgery. In: Journal of Pediatric Surgery. 1998 ; Vol. 33, No. 11. pp. 1641-1644.
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