Error traps in fetal surgery

Abstract

The growth of the field of fetal surgery over the last two decades driven by new indications and data from prospective randomized trials supporting prenatal intervention has resulted in techniques protocols and methodologies that have gained confidence by insuring good outcomes. Error traps are methods or techniques that usually work well in most of the cases, but which are apt to fail under certain specific circumstances. The very confidence the surgeon develops in these techniques or methodologies makes them a trap for the unwary surgeon. The purpose of this article is to discuss common error traps in fetal interventions, including ultrasound guided procedures, fetoscopic surgery, open fetal surgery and EXIT procedures. Awareness of these error traps and approaches to avoid them may enhance fetal surgical outcomes and reduce complications rates.

Keywords: EXIT procedure; FETO; Fetal surgery; Fetoscopic endoluminal tracheal occlusion; Fetoscopic surgery; Laser photocoagulation; Open fetal surgery; Radiofrequency ablation; Twin reversed arterial perfusion sequence; Twin-to-twin transfusion syndrome.