Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, UTHealth The University of Texas McGovern Medical School and the Fetal Center at Children's Memorial Hermann Hospital, Houston, TX, USA.
HeartStitch Inc., Fountain Valley, CA, USA.
Ultrasound Obstet Gynecol. 2024 Sep;64(3):374-380. doi: 10.1002/uog.27646.
To assess the feasibility of using a novel device designed for minimally invasive suturing to anchor fetal membranes to the uterine wall and to close surgical defects after fetoscopy.
We tested the WestStitch™ suturing device both ex vivo and in vivo. In the ex-vivo studies, 12-Fr trocar defects were created with a fetoscope in five specimens of human uterine tissue with fetal membranes attached. Specimens were examined for integrity of the anchoring stitch. For the in-vivo studies, trocar defects were created in the two uterine horns of three pregnant ewes, each carrying twins at approximately 79-90 days' gestation. One trocar defect in each ewe was repaired using the suture device, and the other was left unrepaired as a control. The repair sites were examined for membrane-anchoring integrity when the defect was created and at delivery.
Fetal membranes were anchored successfully to the uterine myometrium using the suture-delivery device in all five experiments performed ex vivo. The in-vivo experiments also revealed successful membrane anchoring compared with controls, both at the time of device deployment and 1-9 weeks after the procedure.
We successfully anchored amniotic membranes to the underlying myometrium using a suturing device, both ex vivo and in vivo. Further studies are needed to evaluate the efficacy of the device and to determine whether it can successfully anchor fetal membranes percutaneously in human patients. © 2024 International Society of Ultrasound in Obstetrics and Gynecology.
评估一种新型微创缝合器械用于将胎膜固定在子宫壁上并关闭羊膜镜检查后手术缺损的可行性。
我们对 WestStitch™缝合器械进行了离体和在体测试。在离体研究中，使用羊膜镜在附有胎膜的五个人体子宫组织标本上创建 12Fr 套管缺陷。检查锚固缝线的完整性。对于在体研究，在三只怀有双胞胎的怀孕母羊的两个子宫角创建套管缺陷，妊娠约 79-90 天。每只母羊的一个套管缺陷使用缝合器械修复，另一个作为对照未修复。在创建缺陷时和分娩时检查修复部位的膜锚固完整性。
在所有 5 个离体实验中，使用缝合输送装置成功地将胎膜固定在子宫平滑肌上。与对照组相比，在体内实验中，在装置部署时和在手术后 1-9 周时，也显示出成功的膜锚固。
我们成功地使用缝合装置将羊膜固定在子宫肌层，无论是在离体还是在体。需要进一步研究来评估该装置的疗效，并确定它是否可以成功地经皮固定在人类患者的胎膜。©2024 年国际妇产科超声学会。
