THE PREGNANT EWE - AN ANIMAL-MODEL FOR FETOSCOPIC SURGERY

Objective: To develop an animal model for fetal endoscopic surgery whi ch could be feasible and reproducible. The aim of this work was to per form a fetoscopy without the need of a laparotomy. Methods: Pregnant e wes underwent under general anesthesia laparoscopy with the creation o f a maternal pneumoperitoneum. After localizing the placenta by transi llumination, we carried out fetoscopy through a 5 mm trocar using a pe rfusion of Ringer's solution. Results: Five video-assisted procedures have been performed. None of the cases has shown any bleeding from myo metrial wounds and no suture was necessary. There was no leakage of am niotic fluid. Intrauterine space was large enough to manipulate instru ments without producing any fetal damage. Sharp visualization and anat omical description of the fetus were precise without the use of CO2. T here were no miscarriages and postnatal examinations of the lambs were normal. Conclusion: Fetoscopic surgery can be performed in the pregna nt sheep without any complications but preterm labor which is the main problem in human fetal surgery, is infrequent in the sheep. Our model is reproducible and simulates the surgical endoscopic procedures whic h will occur in a close future in the human species. Copyright (C) 199 7 Elsevier Science Ireland Ltd.