Fetoscopic Reduction and Closure for Complex Gastroschisis: A Novel Minimally Invasive Prenatal Approach.

Abstract

Gastroschisis is a congenital defect where fetal intestines herniate through an abdominal wall opening. Although postnatal surgical repair is standard, fetal surgery via fetoscopic techniques is emerging as a potential intervention, particularly for complex cases. This case report documents a fetoscopic technique for in utero gastroschisis correction with favorable outcomes. A fetoscopic surgery for gastroschisis was performed at 29 weeks of gestation. Using ultrasound guidance, a fetoscope and two trocars were introduced into the amniotic cavity to reposition the herniated intestines into the fetal abdomen and close the abdominal wall defect with a continuous suture. The procedure was completed in 80 min, with fetal vitality monitored during surgery. A live female newborn was delivered by cesarean section at 32 weeks of gestation for premature rupture of ovular membranes, weighing 1620 g. The newborn demonstrated appropriate gastrointestinal function and was discharged at 14 days without the need for further surgical interventions. This case report demonstrates the feasibility and safety of fetoscopic repair of gastroschisis, resulting in favorable neonatal outcomes, including early discharge without additional surgery. The approach warrants further investigation by randomized clinical trial to evaluate its benefits compared to standard postnatal treatment for gastroschisis, especially in complex suspect cases.

Supplementary information: The online version contains supplementary material available at 10.1007/s13224-025-02187-5.