title: Feasibility of vesicoamniotic shunt insertion in an inanimate model: comparison of fetoscopic and ultrasound-guided techniques.
abstract: OBJECTIVE
  To determine the feasibility of fetoscopic vesicoamniotic shunt insertion (F-VASI) in an inanimate model and to compare F-VASI to ultrasound (US)-guided VASI (US-VASI) with respect to accuracy of shunt placement and overall success rate.
  
  
  METHODS
  An inanimate second-trimester fetus with a replaceable bladder balloon was suspended in a pressurized water tank and localized with US. Fetal position was randomized, the operator was blinded and a 5-Fr Harrison Shunt® decompressed the bladder in both groups. Thirty shunt insertions were performed per group.
  
  
  RESULTS
  Procedure time was longer for F-VASI (15.0 vs. 2.8 min, p < 0.05), although it decreased with practice. F-VASI and US-VASI were similar for adequate depth of insertion (27/30 vs. 27/30, p = 1.0), placement within 1 cm of midline (27/30 vs. 25/30, p = 0.42), bladder puncture (28/30 vs. 28/30, p = 1.0), and overall success rate (27/30 vs. 23/30, p = 0.3).
  
  
  CONCLUSIONS
  F-VASI is feasible in an inanimate model. Overall success rate was similar between the groups, although procedure time was longer for F-VASI. Further study is required to determine whether shunt migration is decreased with F-VASI.
authors.affiliation: Division of General Surgery, London Health Sciences Centre, St. Joseph's Hospital, London, Ontario, Canada.
authors.forename: R J
authors.initials: RJ
authors.lastname: Humphrey
authors.forename: T
authors.initials: T
authors.lastname: Grieci
authors.forename: J
authors.initials: J
authors.lastname: Schmidt
authors.forename: R
authors.initials: R
authors.lastname: Gagnon
authors.forename: V
authors.initials: V
authors.lastname: Han
authors.forename: A
authors.initials: A
authors.lastname: Bütter
mesh_terms: D005315:Fetal Diseases / Q000601:surgery*; D005332:Fetoscopy; D006801:Humans; D008953:Models, Anatomic; D019919:Prosthesis Implantation / Q000379:methods*; D016216:Ultrasonography, Prenatal; D001748:Urinary Bladder Neck Obstruction / Q000601:surgery*