Attualità e prospettive della neurochirurgia fetale

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F.S. PASTORE, M. PATRICOLO, G.M.F. DE CARO, R. GIUFFRÈ

Ann. Ital. Chir., LXIX, 3, 1998

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Fetal surgery failed up to now to correct early in gestation
nervous system pathologies before an irreversible damage
occurs.
The major hindrance is the induction of preterm labour
considered for fetal surgery what rejection is for organ transplantation.
Pharmacological tocolytic control seems an essential
step before a routine surgery is established.
In the meanwhile mininvasive endoscopic surgery holds out
the best promises, minimizing fetal and maternal stress.
There are many convincing experimental evidences that
endoscopic surgery may prevent secondary neurological
damage of spinal cord in the myelomeningocele. Vascularized
latissimus dorsi muscle flap or skin graft were effectively
used, with endoscopic techinques, to create a protective patch
to preserve the nervous tissue from mechanical and/or
chemical damage.
Endoscopic implant of neurons-rich grafts in damaged cerebral
sites, with beneficial behavioural effects and increased
learning capacity in the recipient animal with respect to
controls, disclose further perspectives to fetoscopic surgery.

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