A study on a minimally invasive fetal surgery for diaphragmatic hernia

1997 Fiscal Year Final Research Report Summary

• Project/Area Number: 07507006
• Research Category: Grant-in-Aid for Scientific Research (A)
• Allocation Type: Single-year Grants
• Section: 展開研究
• Research Field: Embryonic/Neonatal medicine
• Research Institution: University of Tokyo
• Principal Investigator: KOZUMA Shiro University of Tokyo, Dept.of Obstetrics and Gynecology, Associate Professor, 医学部・附属病院, 助教授 (10272569)
• Co-Investigator(Kenkyū-buntansha): WADA Fumio Koken CO., LTD., Tsuruoka Factory, Director, 工場長 ; UTSUMI Atsushi Mitsubishi Cable Industries, LTD., Medical Instruments Development section, Dire, 医療機器部, 部長 ; MACHIDA Yoshiya University of Tokyo, Dept.of Obstetrics and Gynecology, Lecturer, 医学部・附属病院, 助手 (40292908) ; UNNO Nobuya University of Tokyo, Dept.of Obstetrics and Gynecology, Lecturer, 医学部・附属病院, 助手 (90193979) ; BABA Kazunori University of Tokyo, Institute of Medical Electronics, Associate Professor, 医学部・附属病院, 助教授 (30181035)
• Project Period (FY): 1995 – 1997
• Keywords: diaphragmatic hernia / endoscopy / fetal surgery / tracheal occlusion

Research Abstract

(1) Development of endoscopes for fetal surgery
Two types of endoscope were developed ; one was for fetal observation and the other for fetal endotracheal occlusion. The outside diameter was 2.4 mm and 3.0 mm respectively.
(2) Development of a balloon catheter for fetal endotracheal occlusion
A balloon (1.2 mm in outside diameter, 5 mm in length and 0.1-0.15 mm in thickness) was made and connected with a silicon tube (0.7 mm in outside diameter and 0.3 mm in inside diameter).
(3) Fetal endotracheal occlusion with a balloon catheter in sheep
A cesarean section was performed in pregnant sheep under halothane anesthesia. A small incision was made on the uterine wall and the tip of an endoscope was inserted into the amniotic fluid through the incision. Lactated Ringer's solution was infused into the amniotic cavity for a wider field of vision. An endoscope for fetal observation was used to guide the tip of the other endoscope to the fetal nostril. However, the procedure of endoscopical guidance was abandoned because of difficulty. Thereupon, the fetal nostril was kept hold of by the operator's hands underneath the incision of the uterine wall and the tip of endoscope was inserted into the nostril. The tip was advanced beyond the epiglottis to the vocal cord and a balloon catheter was successfully placed in the trachea through the working channel of the endoscope.