Fetal Surgery in the Primate 4.0: A New Technique 30 Years Later
- 27 October 2020
- journal article
- research article
- Published by S. Karger AG in Fetal Diagnosis and Therapy
- Vol. 48 (1), 43-49
- https://doi.org/10.1159/000511355
Abstract
Introduction: Open fetal surgery requires a hemostatic hysterotomy that minimizes membrane separation. For over 30 years, the standard of care for hysterotomy in the gravid uterus has been the AutoSuture Premium Poly CS*-57 stapler. Objective: In this study, we sought to test the feasibility of hysterotomy in a rhesus monkey model with the Harmonic ACE®+7 Shears. Methods: A gravid rhesus monkey underwent midgestation hysterotomy at approximately 90 days of gestation (2nd trimester; term = 165 ± 10 days) using the Harmonic ACE®+7 Shears. A two-layer uterine closure was completed and the dam was monitored by ultrasound intermittently throughout the pregnancy. At 58 days after hysterotomy (near term), a final surgery was performed to evaluate the uterus and hysterotomy site. Results: A 3.5-cm hysterotomy was completed in 2 min 7 s. The opening was hemostatic and the membranes were sealed. Immediately after closure and throughout the pregnancy, ultrasound revealed intact membranes without separation and normal amniotic fluid levels. At term, the scar was well healed without signs of thinning or dehiscence. Conclusions: The Harmonic ACE®+7 Shears produced a hemostatic midgestation hysterotomy with membrane sealing in the rhesus monkey model. Importantly, healing was acceptable.Keywords
This publication has 15 references indexed in Scilit:
- Surgical techniques for uterine incision and uterine closure at the time of caesarean sectionEmergencias, 2014
- The making of fetal surgeryPrenatal Diagnosis, 2010
- Absorbable staples for uterine incision at caesarean sectionPublished by Wiley ,1996
- Comparison of Absorbable Uterine Staples and Traditional Hysterotomy During Cesarean DeliveryObstetrics & Gynecology, 1996
- Performance of Cesarean Section Using Absorbable StaplesObstetrical & Gynecological Survey, 1991
- Performance of cesarean section using absorbable staples.1991
- Evaluation of surgical staples in cesarean sectionAmerican Journal of Obstetrics and Gynecology, 1989
- Fetal surgery in the primate III. Maternal outcome after fetal surgeryJournal of Pediatric Surgery, 1986
- Fetal surgery in the primate II. Uterine electromyographic response to operative procedures and pharmacologic agentsJournal of Pediatric Surgery, 1984
- Fetal surgery in the primate I. Anesthetic, surgical, and tocolytic management to maximize fetal—Neontal survivalJournal of Pediatric Surgery, 1982