Fetoscopic coverage of experimental myelomeningocele in sheep using a patch with surgical sealant

ObjectiveAssess the feasibility of a fetoscopic patch coverage method for myelomeningocele repair in a sheep model.Study designExperimental study. A myelomeningocele-like defect was created in 15 fetal sheep on day 75 of gestation. Six remained untreated, whereas 9 underwent fetoscopic coverage of the defect on day 95 of gestation using an inert patch secured with surgical sealant. Clinical and histological examinations were performed after delivery.ResultsFour valid newborn lambs were obtained in each group. Mean fetoscopic surgical time was 26.9 (SD = 7.4) min. All untreated animals had an open lumbar defect with cerebrospinal fluid leakage, paraplegia, urinary incontinence, and Chiari malformation. All treated animals had a closed defect and were able to walk; one had weak bladder control, and another mild Chiari malformation.ConclusionIn a chronic myelomeningocele model in fetal sheep, fetoscopic repair using a sealed patch results in simple, fast, satisfactory neural tube closure and averts neurological damage and Chiari malformation.