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Fetoscopic myelomeningocele repair: standard technique and approaches for closure of large defects

Year: 2026

Type: article

Abstract: Fetoscopic repair of myelomeningocele (MMC) offers a minimally invasive alternative to open prenatal surgery. This approach protects exposed neural tissue while reducing the need for postnatal CSF diversion and lowering maternal morbidity compared to open techniques. In this video, the authors demonstrate a standardized fetoscopic technique for MMC repair using an externalized uterine approach. Key steps include placode release, excision of transitional epithelium, and multilayer closure with a dural substitute. The authors highlight technical pearls for managing myeloschisis and large MMCs, including relaxing incisions and myofascial mobilization, to achieve a tension-free, watertight repair. The video can be found here: https://stream.cadmore.media/r10.3171/2026.1.FOCVID25226.

Source: Neurosurgical Focus Video

DOI: 10.3171/2026.1.focvid25226

Authors: Arjun R. Adapa, Anthony J. Tang, Nicholas Schmoke, Lynn Simpson, Russell Miller, Laurence Ring, Vincent P. Duron, Neil A. Feldstein

Institutions: Columbia University Irving Medical Center, Columbia University

Language: English

Topic: Spinal Dysraphism and Malformations

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7147235662

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