scholarly journals Fetal Myelomeningocele Closure: Technical Considerations

2014 ◽  
Vol 37 (3) ◽  
pp. 166-171 ◽  
Author(s):  
Gregory G. Heuer ◽  
N. Scott Adzick ◽  
Leslie N. Sutton
Keyword(s):  
Randomized Controlled Trial ◽  
Surgical Technique ◽  
General Surgery ◽  
Congenital Malformations ◽  
Controlled Trial ◽  
Spinal Fluid ◽  
Fetal Period ◽  
Randomized Controlled ◽  
Technical Considerations ◽  
Postnatal Closure

Myelomeningocele (MMC) is one of the most common serious congenital malformations. Typically this condition has been treated with closure of the MMC defect shortly after birth. In general, surgery for MMC aims to provide a multilayered closure to provide protection to the neural elements, prevent leakage of spinal fluid and reduce infection risks. A randomized controlled trial, the Management of Myelomeningocele Study (MOMS), has shown that closure during the fetal period can be performed relatively safely and can result in significant benefit to the child. Whereas the surgical technique of prenatal closure of an MMC defect is similar to a postnatal closure, there are some important technical differences. The goal of this paper is to describe the technique of fetal closure of MMC defects, highlight the unique steps that are needed for this surgery and delineate some potential pitfalls.

Computerized Residency Interview Scheduling: A Randomized Controlled Trial of Categorical General Surgery Applicants

2019 ◽  
Vol 76 (1) ◽  
pp. 36-42 ◽  
Author(s):  
Heather E. Hoops ◽  
Karen J. Brasel ◽  
Caroline Q. Stephens ◽  
Erin M. Anderson ◽  
Liane LeBlanc ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
General Surgery ◽  
Controlled Trial ◽  
Randomized Controlled

Computerized Residency Interview Scheduling: A Randomized Controlled Trial of Categorical General Surgery Applicants

2017 ◽  
Vol 225 (4) ◽  
pp. e151-e152
Author(s):  
Heather E. Hoops ◽  
Karen J. Brasel ◽  
Caroline Q. Stephens ◽  
Erin M. Anderson ◽  
Liane LeBlanc ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
General Surgery ◽  
Controlled Trial ◽  
Randomized Controlled

A Randomized Controlled Trial of Video Education versus Skill Demonstration: Which Is More Effective in Teaching Sterile Surgical Technique?

2018 ◽  
Vol 19 (3) ◽  
pp. 303-312 ◽  
Author(s):  
Stephanie N. Pilieci ◽  
Saad Y. Salim ◽  
Daithi S. Heffernan ◽  
Kamal M.F. Itani ◽  
Rachel G. Khadaroo
Keyword(s):  
Randomized Controlled Trial ◽  
Surgical Technique ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Video Education

Intrauterine closure of myelomeningocele: an update

2004 ◽  
Vol 16 (2) ◽  
pp. 1-4 ◽  
Author(s):  
Noel Tulipan
Keyword(s):  
Randomized Controlled Trial ◽  
Congenital Malformations ◽  
State Of The Art ◽  
Controlled Trial ◽  
Preliminary Evidence ◽  
Endoscopic Techniques ◽  
Randomized Controlled ◽  
Risks And Benefits ◽  
Myelomeningocele Repair ◽  
Intrauterine Closure

Preliminary evidence suggests that intrauterine myelomeningocele repair may benefit patients by reducing the both incidence of hydrocephalus and the severity of the Chiari malformation; however, this benefit remains unproved. Furthermore, the procedure entails substantial risks not associated with conventional therapy. A randomized controlled trial of intrauterine and conventional therapies is underway. This study should definitively establish the procedure-related risks and benefits. Regardless of the outcome, it is clear that the risks of intrauterine intervention need to be reduced before myelomeningocele, or other congenital malformations, can be effectively treated prior to birth. To that end, studies are being conducted to assess the potential advantages of applying state-of-the-art endoscopic techniques to intrauterine therapy. If benefit can be proven and risks reduced, intrauterine myelomeningocele repair has the potential to become the preferred therapy for patients suffering from this debilitating disease.

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