title: Fetoscopic management of gastroschisis in a lamb model.
abstract: BACKGROUND
  Gastroschisis is a malformation consisting of an abdominal wall defect with eviscerated bowel. Its standard treatment is postnatal repositioning or temporary prosthetic bag placement. The aim of our study is to evaluate the feasibility of its fetoscopic management in a lamb model.
  
  
  METHODS
  At mid-gestation (day 75), gastroschisis was created in eight German blackhead sheep. A second fetoscopic procedure was performed on day 105, assessing the viability, extension, and potential for repositioning of eviscerated bowel. The fetus was retrieved by Cesarean section on day 132 and evaluated.
  
  
  RESULTS
  In six fetuses gastroschisis could be successfully created and assessed with fetoscopy. Two fetuses were lost due to technical complications. Primary repair by repositioning the intestine into the abdomen was not possible because it grew into an inflammatory conglomerate too large for the small fetal abdominal cavity.
  
  
  CONCLUSIONS
  Although technically demanding, we were able to produce and reassess six cases of gastroschisis by fetoscopy. As primary repositioning appears unfavorable, fetoscopic prosthetic bag placement may become an alternative.
authors.affiliation: Department of Pediatric Surgery, UKE: University Hospital Eppendorf, Altona Children's Hospital, Bleickenallee 38, 22767, Hamburg, Germany. robert@bergholz-berlin.de
authors.forename: Robert
authors.initials: R
authors.lastname: Bergholz
authors.forename: Thomas
authors.initials: T
authors.lastname: Krebs
authors.forename: Katharina
authors.initials: K
authors.lastname: Wenke
authors.forename: Thomas
authors.initials: T
authors.lastname: Andreas
authors.forename: Bastian
authors.initials: B
authors.lastname: Tiemann
authors.forename: Julia
authors.initials: J
authors.lastname: Paetzel
authors.forename: Birte
authors.initials: B
authors.lastname: Jacobsen
authors.forename: Rebecca
authors.initials: R
authors.lastname: Fahje
authors.forename: Carla
authors.initials: C
authors.lastname: Schmitz
authors.forename: Oliver
authors.initials: O
authors.lastname: Mann
authors.forename: Beate
authors.initials: B
authors.lastname: Roth
authors.forename: Birgit
authors.initials: B
authors.lastname: Appl
authors.forename: Kurt
authors.initials: K
authors.lastname: Hecher
mesh_terms: D000818:Animals; D005316:Fetal Distress / Q000601:surgery*; D005332:Fetoscopy / Q000379:methods*; D020139:Gastroschisis / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D034561:Sheep, Domestic; D013997:Time Factors