IF 2.1 3区 医学 Q3 CLINICAL NEUROLOGY Journal of neurosurgery. Pediatrics Pub Date : 2024-12-20 DOI:10.3171/2024.9.PEDS24239
Sergio Cavalheiro, Marcos Devanir Silva da Costa, Mauricio Mendes Barbosa, Patrícia Alessandra Dastoli, Stéphanno Gomes Pereira Sarmento, Ítalo Capraro Suriano, David Pares, Cid Ura Kusano, Antônio Fernandes Moron
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引用次数: 0

摘要

目的:作者旨在描述一种低成本、易复制的布鲁纳和图利潘手术改良方法,以保留子宫肌纤维。他们对 10 名孕妇进行了回顾性队列研究,这些孕妇的胎儿出现了腰骶部脊髓膜膨出症(MM)。他们采用管状单孔内窥镜辅助技术,通过胎儿神经外科手术修复了腰骶部肌膜囊肿:本研究于2020年1月至2023年6月期间在圣若阿纳医院和圣保罗医院进行。手术包括在不切除子宫壁的情况下从子宫体中牵引环状纤维。在不切断子宫肌纤维的情况下,使用直径逐渐增大的管状装置进行牵拉,并使用直径为25毫米的管状牵引器,在内窥镜辅助下利用显微外科技术闭合MM:平均出生年龄为 36 周 3 天。所有病例均可进行缺损修复。平均手术时间为 130 分钟。其中两名患者出现了脑积水。一名患者接受了脑室腹腔分流术,另一名患者接受了内镜下第三脑室造口术和脉络丛凝固术:该手术避免了子宫壁的切除,为内窥镜辅助下的显微外科技术提供了工作空间,可能是未来使用机器人技术进行单孔矫正的第一步。
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Tubular single-port endoscope-assisted surgery for fetal myelomeningocele repair.

Objective: The authors aimed to describe a low-cost and easily reproducible alteration of the Bruner and Tulipan procedure to preserve uterine muscular fibers. They conducted a retrospective cohort study of 10 pregnant women whose fetuses developed lumbosacral myelomeningocele (MM). The MM was repaired through a fetal neurosurgical procedure using a tubular single-port endoscope-assisted technique.

Methods: This study was conducted at the Santa Joana Hospital and São Paulo Hospital between January 2020 and June 2023. The procedure consisted of tubular retraction of circular fibers from the uterine body without excision of the uterine wall. Tubular devices with progressively larger diameters were used for retraction without cutting the uterine muscular fibers, and a 25-mm-diameter tubular retractor was used to allow endoscope-assisted closure of the MM using microsurgical techniques.

Results: The average birth age was 36 weeks 3 days. Defect repair was possible in all cases. The mean surgical time was 130 minutes. Two of the patients developed hydrocephalus. One patient underwent a ventriculoperitoneal shunt, and the other underwent endoscopic third ventriculostomy with choroid plexus coagulation.

Conclusions: This procedure avoids excision of the uterine wall, promotes a workspace for microsurgical techniques assisted by endoscopy, and is possibly the first step for future single-port correction using robotic techniques.

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来源期刊
Journal of neurosurgery. Pediatrics
Journal of neurosurgery. Pediatrics 医学-临床神经学
CiteScore
3.40
自引率
10.50%
发文量
307
审稿时长
2 months
期刊介绍: Information not localiced
期刊最新文献
The extreme lateral transodontoid approach for large tumors in children in the ventral craniocervical junction. Tubular single-port endoscope-assisted surgery for fetal myelomeningocele repair. False alarms and the burden of shunt failure in pediatric patients with hydrocephalus: a longitudinal study. The epidemiology and management of spontaneous spinal epidural abscesses in children: a single-center experience. Corpus callosotomy for intractable epilepsy: a contemporary series of operative factors and the overall complication rate.
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