An experimental animal model of intestinal obstruction to simulate in utero therapy for jejunoileal atresia

Objective: To obtain 'intestinal atresia-like' conditions in the fetal Lamb model to subsequently allow in utero surgical repair. Methods: Six time-da ted pregnant sheep underwent general anesthesia at 75 days of gestation (te rm 145 +/- 5 days). After maternal laparotomy and hysterotomy, the fetal ab domen was opened. Once the jejunoileal intestinal loop was identified, the mesenteric vessels were isolated, ligated, and sectioned in 2 fetuses, and in the remaining 5 fetuses the bowel loop was ligated. Two further fetuses were used as controls and underwent sole laparotomy. Of the group of 7 fetu ses 2 were reoperated at 100-105 days of gestational age and underwent inte stinal recanalizatian. Eight fetuses were delivered at term by cesarean sec tion and the remaining 1 by spontaneous delivery. One newborn underwent neo natal entero-enteric anastomosis. Results: 4 out of 6 fetuses survived, in utero intestinal or vascular ligation having provoked an 'intestinal atresi a-like' picture. The animal. operated at birth died. The 2 control fetuses and the 2 fetuses with in utero intestinal recanalization survived until te rm. Conclusion: The present study shows that in utero treatment of intestin al obstruction is possible in an experimental model.