The Art of Fetoscopy: A Step Toward Minimally Invasive Fetal Therapy

摘要

Purpose To study the feasibility, learning curve, and safety of fetoscopy, so that fetal surgery can be confidently performed in ongoing pregnancies. Methods Fetoscopy was performed at 12–20?weeks of gestation, in 12 women with fetal congenital malformations and/or for termination of pregnancy, under local anesthesia using fine fetoscopes ranging from 1 to 2-mm diameter. The fetal parts and placenta were examined for clarity of vision, identification, and anomalies. Results Fetoscopy required great skill, patience, and extensive use of ultrasound for correct orientation. Visualization was better with endoscope of 2-mm diameter. Laser coagulation of placental vessels using diode laser system was possible in the last two cases. There were no major complications. Conclusions Fetal endoscopy is a feasible procedure, safe in experienced hands but has an appreciable learning curve.