Development of a simulator for training of fetoscopic myelomeningocele surgery

Jochem K H Spoor, Lis van Gastel, Fatima Tahib, Amanda van Grieken, Willem van Weteringen, Frank Sterke, Ahmet A Baschat, Jena L Miller, Tjeerd H R de Jong, René M H Wijnen, Alex E Eggink, Philip L J DeKoninck*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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OBJECTIVE: To develop a realistic simulation model for laparotomy-assisted fetoscopic spina bifida aperta (SBa) surgery, to be used for training purposes and preoperative planning.

METHODS: The predefined general requirement was a realistic model of an exteriorized uterus, allowing all neurosurgical steps of the intervention. The uterus was modelled using ultrasound and MRI images of a 25 weeks' gravid uterus, consisting of flexible polyurethane foam coated with pigmented silicone. The fetal model, contained an opening on the dorsal side for a customizable spinal insert with all the aspects of a SBa, including a cele, placode, and myofascial and skin layer. The model was assessed in a series of validation experiments.

RESULTS: Production costs are low, uterus and fetus are reusable. Placental localization and the level and size of the spinal defect are adjustable, enabling case-specific adaptations. All aspects of the simulator were scored close to realistic or higher for both appearance and functional capacities.

CONCLUSIONS: This innovative model provides an excellent training opportunity for centers that are starting a fetoscopic SBa repair program. It is the first simulation model with adjustable spinal defect and placental localisation. Further objective validation is required, but the potential for using this model in preoperative planning is promising.

Original languageEnglish
Pages (from-to)355-358
Number of pages4
JournalPrenatal Diagnosis
Issue number3
Publication statusPublished - Mar 2023

Bibliographical note

Funding information: Sophia Children's Hospital Foundation, Grant/Award Number: CAM19‐11

Publisher Copyright: © 2023 The Authors. Prenatal Diagnosis published by John Wiley & Sons Ltd.


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