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Intrauterine hematoma evacuation during fetoscopic myelomeningocele repair: a novel application of the NICO Myriad

Year: 2026

Type: article

Abstract: Evacuating intrauterine hematomas during fetoscopic myelomeningocele repair can be challenging. The NICO Myriad (Stryker Inc.) has been previously described to resect brain tumors, as an adjunct in intraventricular neuroendoscopy, and, most recently, has been proven to effectively remove intracerebral hematomas at clinical and cost-effective significance. This device has not been described in fetal neurosurgery. In this video, the NICO Myriad was utilized during a minilaparotomy fetal myelomeningocele repair to mechanically aspirate an intrauterine hematoma noted at the end of the operation. The surgical technique and technical nuances of using the NICO Myriad during fetoscopic myelomeningocele repair are reviewed. The video can be found here: https://stream.cadmore.media/r10.3171/2026.1.FOCVID25233.

Source: Neurosurgical Focus Video

DOI: 10.3171/2026.1.focvid25233

Authors: Raj Swaroop Lavadi, Michael C. Sundahl, Kyle Ortiz Rodriguez, Brittany J. Arkerson, Anas Aljabari, Laurie L. Ackerman, Rabia Qaiser, Jignesh Tailor, Thomas Larrew, Charles B. Stevenson, Ramen H. Chmait, Hiba J. Mustafa, Jason Chu

Institutions: Indiana University Indianapolis, Indiana University School of Medicine, Indiana University Hospital, Riley Hospital for Children, Indiana University – Purdue University Indianapolis, University of Southern California

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: W7147736946

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