Adverse outcomes following endoscopic repair of a fetal cleft lip using anovine model

Objective: The purpose of this study was to determine if endoscopic techniq ues could be used to repair an epithelialized lip cleft with accuracy and w ith an outcome comparable to fetuses treated through an open hysterotomy. Interventions and Results: In contrast to previous open fetal cleft lip rep airs in the same model, none of the five fetuses reported here had a good a esthetic result. Although there was no evidence of scar histologically, the edges of the lip were poorly approximated. The epithelial lining and under lying dermis of the wound margins were notably inverted. The orbicularis or is muscle, which had been reapproximated, appeared thin and hypoplastic, Mo st of the vermilion elements were poorly aligned, and in one animal, there was a complete dehiscence of the repair. Conclusions: In a more representative model of cleft tip that is not an acu te tip wound, in utero endoscopic suture repair of the ovine lip gave a poo r result using current technology. Only a meticulously performed, multilaye red, open repair of a cleft appears to give a good cosmetic and functional outcome. Further studies to improve the endoscopic repair as our technology advances are therefore warranted.