Fetal Surgery
Also covered as: myelomeningocele · congenital diaphragmatic hernia · pulmonary hypoplasia · hydrops · hydrocephalus · spina bifida · hindbrain herniation · ascites
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Answers come only from this collection's statement ledger and cite the exact moment · not medical advice
Content of this collection
Diagnosis & Workup
3 items
Overview of Prenatal Diagnosis: Cincinnati Fetal Center
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Dr. Mark P. Johnson, research chair in fetal therapy, discusses an overview of prenatal diagnosis of fetal lower urinary tract obstruction. Dr. Johnson describes the most common causes of lower urinary tract obstructions, progressive oligoh
video · 40:34 · Nov 2018
Prenatal diagnosis of fetal lower urinary tract obstruction: Fetal...
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Dr. Mark P. Johnson, research chair in fetal therapy, discusses an overview of prenatal diagnosis of fetal lower urinary tract obstruction. Dr. Johnson describes the most common causes of lower urinary tract obstructions, progressive oligoh
video · 40:14 · Jan 2019
Utility of Fluorescence In Situ Hybridization as a Fetal Surgery Eligibility Criterion for....
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Lizzy Lee from Cincinnati Children's discusses a pertinent study on the utility of invasive genetic testing, specifically Fluorescence In Situ Hybridization (FISH), prior to fetal surgery. The research questions whether FISH provides additi
video · 0:52 · Jun 2026
Surgical Management
17 items
Controversies in Congenital Diaphragmatic Hernia: Update Course 2018
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At the 6th Annual Pediatric Surgery Update Course, Dr. Mark Wulkan discusses controversies in congenital diaphragmatic hernia including advantages of open versus minimally invasive repair (with visualization of technique), timing of CDH rep
video · 41:42 · Sep 2018
Urologic Fetal Intervention: Cincinnati Fetal Center
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Dr. Pramod Reddy, Division of Pediatric Urology, discusses fetal cystoscopy. Dr. Reddy discusses fetal intervention and risks, urinary tract obstructions, open intervention versus fetoscopic intervention, the risks of shunt usage for renal
video · 61:40 · Nov 2018
Fetal Interventions Part II: Lung Lesions
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Dr. Alan Flake leads a discussion in fetal interventions for prenatally-diagnosed lung lesions.
video · 16:30 · Jan 2019
Pediatric Hernia: Update Course 2013
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During the first annual Stay Current in Pediatric Surgery Update Course in 2013, Dr. Peter Mattei, general, thoracic and fetal surgery, of The Children's Hospital of Philadelphia, discusses hernia management. Topics of discussion include in
video · 52:50 · Jan 2019
Fetal urological aspect: Fetal Genitourinary Disease 2015
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Dr. Pramod Reddy discusses fetal cystoscopy, includingfetal intervention and risks, urinary tract obstructions, open intervention versus fetoscopic intervention, the risks of shunt usage for renal functions, normal fetal fluid pressure rang
video · 59:23 · Jan 2019
Fetoscopic endoluminal tracheal occlusion and twin-twin transfusion: Fetal...
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Dr. Yan Deprest, Professor of Obstetrics GYN, University Hospitals Gasthuisberg. Leuven, Belgium, discusses fetoscopic endoluminal tracheal occlusion. His presentation provides insight on the percutaneous procedure, trocar insertion, delive
video · 149:16 · Jan 2019
Open Fetal Surgery Overview: Fetal Surgery 2012
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Dr. Flake, attending surgeon and director of the General Surgery Fellowship Program at The Children's Hospital of Philadelphia,presents a brief overview of open fetal surgery. Topics discussed include the prenatal diagnosis of an abnormal f
video · 37:55 · Jan 2019
Lung Lesions: Fetal Interventions Parts I+II
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Dr. Alan Flake leads a discussion in fetal interventions for prenatally-diagnosed lung lesions.
video · 30:56 · Jan 2019
Fetal Interventions Part I: Lung Lesions
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Dr. Alan Flake leads a discussion in fetal interventions for prenatally-diagnosed lung lesions.
video · 14:27 · Jan 2019
Prenatal Management of CPAMs: Lung Lesions
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Dr. Alan Flake discusses prenatal management of congenital pulmonary airway malformations (CPAMs). It includes two videos of examples of fetal surgery.
video · 18:16 · Jan 2019
Neonatal Lung Lesions with Dr. Steven Rothenberg
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Dr. Steven Rothenberg discusses Newborn Lung Lesions with Dr Todd Ponsky. Edited by Ian C. Glenn, MD & Nicholas E. Bruns, MDPrenatal evaluationPatients with prenatal diagnosis of cystic lung lesions are referred for prenatal evaluation and
podcast · 66:58 · Dec 2020
Fetoscopic Endoluminal Tracheal Occlusion (FETO)
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Did you know that we can do surgery on a fetus? In today's episode, we hear from Dr. Foong-Yen Lim, M.D. about Fetoscopic Endoluminal Tracheal Occlusion or FETO to treat Congenital Diaphragmatic Hernia (CDH) with Host Rod Gerardo, M.D.
podcast · 5:54 · Jul 2021
Fetoscopic Repair of Myelomeningocele (MMC)
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Continuing our series on Fetal Surgery, today's episode reviews the basics of fetoscopic repair of myelomeningocele with Dr. Foong-Yen Lim, M.D. Host: Rod Gerardo
podcast · 5:52 · Aug 2021
Treatment for Long Gap Esophageal Atresia: Esophageal Elongation and Replacement
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Pediatric surgeons Dr. Daniel Von Allmen and Dr. Todd Ponsky from Cincinnati children's Hospital discussing the technique for treating long gap esophageal atresia. For additional info please visit: https://www.youtube.com/c/CincinnatiChildr
podcast · 10:56 · Jan 2022
Myelomeningoceles (open spina bifida) -Fetoscopic Intrauterine Myelomeningocele Closure
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In this educational video from Lurie Children’s Hospital, Dr. Robin Bowman walks us through a fetoscopic intrauterine myelomeningocele (MMC) closure, a cutting-edge surgical intervention for open neural tube defects diagnosed in utero.Key H
video · 3:41 · Dec 2025
Inside a FETO Procedure: Fetoscopic Balloon Tracheal Occlusion with Dr. Beth Rymeski
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This video, featuring Dr. Beth Rymeski from Cincinnati Children's, details the procedural aspects of Fetoscopic Endoluminal Tracheal Occlusion (FETO). It explains how a fetoscope is used to insert and inflate a balloon in the fetal trachea,
video · 4:30 · Jul 2026
Inside a FETO Procedure: Fetoscopic Balloon Tracheal Occlusion with Dr. Beth Rymeski
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This video, presented by Dr. Beth Rymeski of Cincinnati Children's Hospital, details the procedural aspects of Fetal Endoluminal Tracheal Occlusion (FETO). It explains how a fetoscope is used to insert a balloon into the fetal trachea to te
video · 4:30 · Jul 2026
Evidence & Research
7 items
Fetal Surgical Intervention for Myelomeningocele: Fetal Surgery 2012
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Dr. Adzick is the surgeon-in-chief and director of the Center for Fetal Diagnosis and Treatment at The Children’s Hospital of Philadelphia (CHOP). He gives his presentation on myelomeningocele (MMC), the most severe form of spin bifida. Top
video · 165:47 · Jan 2019
Journal of Pediatric Surgery Article Review: January 2022 APSA Issue
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We're back with the January issue of JPS article highlights. This time we're talking to editor Dr. Cassandra Kelleher and authors Drs. Gail Besner, Shahrazad Joharifard and Sarah Stokes with Dr. Todd Ponsky. Hosts: Ellen Encisco, Em Tombash
podcast · 13:09 · Feb 2022
Update Course 2021: TOP PUBLICATIONS IN NON - PED SURG JOURNALS
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Dr. Jose Campos and his team, Sociedad Chilena Cirugia Pediatrica curate the best pediatric surgical articles in non-core pediatric surgery journals and in this session, they describe their 5 favorites from the past year. The conversation i
video · 22:13 · May 2022
Journal of Pediatric Surgery Article Highlights: April 2022
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We're back with the April issue of JPS article highlights. This time we're talking to Dr. Paul Tam and authors Dr. Natalie Lopyan and Dr. Christina Theodorou. Hosts: Em Tombash, Rod Gerardo, Brittany Levy Lopyan NM, Perrone EE, Gadepalli SK
podcast · 8:38 · Jul 2022
Update Course 2022 - APSA PDC UPDATES - Mary Edwards, Paul Jeziorczak, Craig Lillehei, and Charles Snyder,
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In this session, members of the APSA Professional Development Committee (PDC) discussed the latest top articles and practice updates. We were joined by Drs. Mary Edwards, Paul Jeziorczak, Craig Lillehei, and Charles Snyder.
Topics discus
video · 64:30 · Sep 2022
Tracheomalacia and tracheomegaly in infants and children with congenital diaphragmatic hernia managed with and without fetoscopic endoluminal tracheal occlusion (FETO): a multicentre, retrospective cohort study
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David Basurto, Kanokwaroon Watananirun, Anne-Gael Cordier, Juan Otaño, Diane Carriere, Marianna Scuglia, Anna Moraes de Luna Freire Vargas, Jordi Prat, Francesca Maria Russo, Anne Debeer, Cleisson Fábio Andrioli Peralta, Paolo De Coppi, Edu
video · 0:59 · Oct 2024
Quick Literature Updates Ep 19
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We’re back with nineteenth episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review articles covering the most int
video · 4:27 · May 2025
In-Depth Reviews
2 items
The Full Story on CPAMs
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Here we cover Congenital Pulmonary Airway Malformations (CPAMs) through a story with the help of Dr. Todd Ponsky, Dr. Pam Choi, Dr. Beth Rymeski, Dr. Jacob Langer, and Dr. Steven Rothenberg. Hosts: Ellen Encisco & Rod GerardoChapter 1: Pren
podcast · 56:08 · Sep 2021
Open Fetal Surgery & EXIT Procedure with Dr. Jose Peiro
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Join us for an insightful discussion with Dr. Jose Peiro, pediatric surgeon and director of endoscopic fetal surgery at Cincinnati Children’s Fetal Care Center, which is the highest-volume fetoscopic center in the nation. Dr. Peiro walks us
video · 10:23 · Oct 2024
Emerging & Future Directions
1 item
The fetal frontier: A review of current and emerging fetal therapies for genetic diseases
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Lizzy Lee from Cincinnati Children's discusses a pivotal review on 'The Fetal Frontier,' highlighting emerging therapies for genetic diseases. This video explores the innovative approaches of treating genetic conditions in the womb, leverag
video · 0:44 · May 2026
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Every statement below comes from the recorded discussions, with its speaker and moment.
Utility of Fluorescence In Situ Hybridization as a Fetal Surgery Eligibility Criterion for....
Many centers require genetic testing to rule out chromosome abnormalities before fetal surgery, even when ultrasounds and blood tests already look reassuring
clinicalLizzie Lee0:09 ↗
A study reviewed nearly 1000 pregnancies evaluated for fetal surgery
epidemiologicalLizzie Lee0:23 ↗
When imaging and cell-free DNA screening showed low risk for aneuploidy, the FISH test matched those results 100% of the time
clinicalLizzie Lee0:23 ↗
For low-risk pregnancies, FISH did not provide any new information that changed surgery candidacy
clinicalLizzie Lee0:36 ↗
In carefully selected low-risk cases, non-invasive screening may be enough, potentially avoiding the FISH procedure
opinionLizzie Lee0:42 ↗
Inside a FETO Procedure: Fetoscopic Balloon Tracheal Occlusion with Dr. Beth Rymeski
FETO is a percutaneous intervention on the mother using one trocar placed through the maternal abdominal wall into the uterus
clinicalBeth Rymeski0:33 ↗
The procedure uses a standard fetoscope with a side channel through which the balloon is worked
clinicalBeth Rymeski0:42 ↗
The goal of FETO is to allow fluid to stay in the lungs and allow the lungs to expand and grow
clinicalJill Knepprath0:47 ↗
FETO helps prevent pulmonary hypoplasia, which is a big factor in poor outcomes for CDH babies
clinicalJill Knepprath0:53 ↗
The tongue is an easy landmark when doing FETO because it is bumpy
clinicalBeth Rymeski1:21 ↗
Fluid is hooked up to the scope and can be intermittently turned on and off to push tissue away from the scope to allow easier advancement
clinicalBeth Rymeski1:29 ↗
If the baby's head is not perfectly in alignment with the scope, twisting and turning is required to navigate through the mouth
clinicalBeth Rymeski1:38 ↗
The epiglottis is a key landmark to identify when navigating to find the correct location
clinicalBeth Rymeski1:58 ↗
Excessive torquing of the membranes should be avoided because the scope goes through the abdominal wall and uterine wall, and excessive turning can cause membrane damage
clinicalBeth Rymeski2:23 ↗
The scope should always be advanced until the carina is visualized, which confirms tracheal (not esophageal) placement and indicates position within the trachea
clinicalBeth Rymeski2:36 ↗
The balloon should not be driven into one side of the trachea or the other; it should inflate in the main trachea
clinicalBeth Rymeski2:56 ↗
The scope is backed up as the balloon is inflated so that balloon inflation can be watched
clinicalBeth Rymeski3:03 ↗
The balloon is filled with water, around 0.65 to 0.8 mL, depending on the size of the trachea
clinicalJill Knepprath3:08 ↗
The balloon contains a little metal ball that can be visualized
clinicalBeth Rymeski3:29 ↗
Sometimes the trocar advances into the mouth during the procedure and needs to be backed out
clinicalBeth Rymeski3:33 ↗
Final confirmation requires advancing the scope one more time to verify the balloon is below the vocal cords and in the main trachea
clinicalJill Knepprath3:40 ↗
FETO is a percutaneous intervention on the mother using one trocar placed through the abdominal wall into the uterus
clinicalBeth Rymeski0:33 ↗
The procedure uses a standard fetoscope with a side channel through which the balloon is worked
clinicalBeth Rymeski0:42 ↗
The goal of FETO is to allow fluid to stay in the lungs and allow the lungs to expand and grow
clinicalJill Knepprath0:47 ↗
FETO helps prevent pulmonary hypoplasia, which is a big factor in poor outcomes for CDH babies
clinicalJill Knepprath0:53 ↗
The tongue is an easy landmark during FETO because it is bumpy
clinicalBeth Rymeski1:21 ↗
Fluid is hooked up to the scope and can be intermittently turned on and off to push tissue away and allow easier advancement
clinicalBeth Rymeski1:29 ↗
If the baby's head is not perfectly aligned with the scope, twisting and turning is required to navigate through the mouth
clinicalBeth Rymeski1:38 ↗
The epiglottis is sought as a landmark to guide navigation
clinicalBeth Rymeski1:58 ↗
Excessive torquing of the membranes should be avoided because the scope goes through the abdominal and uterine walls and could cause membrane damage
clinicalBeth Rymeski2:23 ↗