King Faisal Specialist Hospital & Research Centre (KFSHRC) in Riyadh has achieved a significant milestone in foetal medicine by successfully performing the Middle East’s first in utero endoscopic surgery to correct a congenital spinal defect in a 26-week-old foetus. The procedure, which marks a notable advancement in prenatal interventions for spina bifida, was carried out using minimally invasive techniques.
The surgical team employed a foetal endoscope to create three small incisions, each measuring no more than 2 millimetres, in the uterus at the site of the foetus’s back. Throughout the procedure, continuous ultrasound monitoring was utilised to guide the surgeons. The congenital defect was successfully repaired, ensuring complete protection of the spinal cord.
Dr Saud Alshanafey, Director of the Foetal Diagnosis and Therapy Program and lead surgeon, explained the significance of this approach: “The novelty of this procedure lies in repairing the congenital defect using a minimally invasive foetal endoscope through incisions no larger than 2 millimetres, avoiding the need to open the uterus, which positively impacts the health of the mother and the pregnancy.”
Advantages over postnatal intervention
Traditionally, spina bifida is addressed through postnatal surgery to prevent infections in the nervous system. However, this method may not fully prevent neurological complications arising from the exposure of the spinal cord during pregnancy. The in utero intervention aims to enhance the baby’s future health and development while reducing the likelihood of complex surgeries after birth.
Spina bifida affects 1 in every 1,000 to 2,000 births globally. The condition results from incomplete closure of the neural tube during early foetal development, leading to exposure of the spinal cord to amniotic fluid. This exposure can affect the nerves of the lower limbs, bladder, and lower digestive system, potentially accompanied by hydrocephalus. Consequently, patients may experience movement disorders, neurological dysfunctions, and urinary issues.
Implications for foetal medicine
This pioneering procedure represents a significant advancement in foetal surgery and highlights KFSHRC’s commitment to providing cutting-edge healthcare. Dr Alshanafey said: “This achievement reflects significant medical advancements in foetal surgery and highlights KFSHRC’s commitment to providing the highest standards of healthcare to improve the quality of life for foetuses and their families in the Kingdom and beyond.”
The success of this procedure opens new avenues for prenatal interventions in the Middle East, potentially improving outcomes for foetuses diagnosed with spina bifida and other congenital defects amenable to in utero correction.
