Inside a FETO Procedure: Fetoscopic Balloon Tracheal Occlusion with Dr. Beth Rymeski
With Dr. Beth Rymeski · hosted by Dr. Jill Knepprath
Cued at 1:48 · stops at 2:33 · press play
Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
FETO is a percutaneous intervention on the mother using one trocar placed through the maternal abdominal wall into the uterus.
A standard fetoscope with a side channel is used, and the balloon is worked through the side channel.
The tongue is an easy landmark to identify during FETO because it is bumpy in appearance.
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.
If the baby's head is not perfectly in alignment with the scope, twisting and turning is required to navigate through the mouth.
The epiglottis is a key landmark to identify when navigating toward the trachea.
Excessive torquing of the membranes should be avoided because the trocar goes through the abdominal wall and uterine wall, and excessive turning can cause membrane damage.
The scope should always be advanced until the carina is visualized to confirm position in the trachea and determine location within the trachea.
The balloon should not be driven into one side of the trachea or the other; it should inflate in the main trachea.
The scope is backed up as the balloon is inflated so that balloon inflation can be watched.
The goal of FETO is to allow fluid to stay in the lungs and allow the lungs to expand and grow.
FETO helps prevent pulmonary hypoplasia, which is a big factor in poor outcomes for CDH babies.
The balloon is filled with water, around 0.65 to 0.8 mL, depending on the size of the trachea.
After balloon deployment, the scope is advanced one more time to confirm that the balloon is below the vocal cords and in the main trachea.