Inside a FETO Procedure: Fetoscopic Balloon Tracheal Occlusion with Dr. Beth Rymeski
With Dr. Dr. Beth Rymeski · hosted by Dr. Jill Knarath
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 abdominal wall into the uterus
The procedure uses a standard fetoscope with a side channel through which the balloon is worked
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 tongue is an easy landmark during FETO because it is bumpy
Fluid is hooked up to the scope and can be intermittently turned on and off to push tissue away and allow easier advancement
If the baby's head is not perfectly aligned with the scope, twisting and turning is required to navigate through the mouth
The epiglottis is sought as a landmark to guide navigation
Excessive torquing of the membranes should be avoided because the scope goes through the abdominal and uterine walls and could cause membrane damage
The scope should always be advanced until the carina is visualized to confirm tracheal position and determine location within the trachea
The balloon should not be driven into one side of the trachea but should inflate in the main trachea
The scope is backed up as the balloon is inflated to allow visualization of balloon inflation
The balloon is filled with water, around 0.65 to 0.8 mL, depending on the size of the trachea
The balloon contains a small metal ball that can be visualized
Final confirmation requires visualizing that the balloon is below the vocal cords and in the main trachea