Better Fetoscopic Outcomes with the Needle Lasso Method
Advanced techniques in fetoscopic spina bifida repair are vital for modern fetal intervention. Specifically, secure amniotic membrane plication reduces the risk of preterm birth after these complex surgeries. However, surgeons often find direct suturing of the port site technically difficult. Consequently, a team of experts developed a novel needle lasso technique to address this challenge.
The Needle Lasso Technique for Fetoscopic Spina Bifida Repair
This method facilitates precise suturing during laparotomy-assisted procedures. Moreover, the needle lasso allows for full-thickness sutures around the port tract, even when direct access is limited. Researchers achieved successful membrane plication in all study cases using this approach. Furthermore, every patient in the treatment group delivered beyond 34 weeks of gestation. Notably, no patients experienced membrane-related complications during the follow-up period.
Clinical Results and Future Implications
Therefore, these findings suggest the technique is highly feasible for clinical practice. In addition, the method might have broader applications in various other fetoscopic surgeries. Similarly, improving port closure remains a priority for reducing iatrogenic complications and improving maternal-fetal safety. Larger studies will eventually confirm these results and potentially change standards of care in specialized fetal centers.
Frequently Asked Questions
Q1: Why is amniotic membrane plication important in fetal surgery?
Amniotic membrane plication secures the membrane against the uterine wall, which prevents separation and reduces the likelihood of preterm prelabor rupture of membranes.
Q2: How does the needle lasso technique improve port closure?
This method enables surgeons to place full-thickness sutures precisely around the port tract, even in cases where direct visualization or manual suturing is difficult.
References
- Demehri FR et al. A Needle Lasso Method for Port Site Closure and Amniotic Membrane Plication in Fetoscopic Surgery. BJOG. 2026 Apr 27. doi: 10.1111/1471-0528.70252. PMID: 42045080.
- Chmait RH et al. Percutaneous/mini-laparotomy fetoscopic repair of open spina bifida. Am J Obstet Gynecol. 2022.
- Shirki S et al. Fetoscopic Observation of Intrauterine Operative Port Placements during Laparotomy-Assisted Fetal Myelomeningocele Closure. Fetal Diagn Ther. 2025.