Course program

Friday, March 20th

08:30 h - Welcome. Introduction.
09:00 h - Basic concepts in Spina bifida. Embryology. First and second hit. Animal models. Physiopathology.
09:20 h - Prenatal diagnosis - Ultrasounds first and second trimester. Anatomical and functional level. 09:40 h - Prenatal diagnosis - Fetal MRI (Dr. Usha Nagaraj VIRTUAL)
10:00 h - Intake of patient - phases of counseling - nurse coordinator (Erinn Goetz VIRTUAL)
10:10 h - Phase I. Postnatal vs prenatal repair. MOMS trial. Inclusion criteria for prenatal repair. 10:20 h - Phase II. Pros and cons. Risks of prenatal surgery.
10:30 h - Phase III. Options for open/ Fetoscopic SB repair. Consents. Preoperative management.
10:40 h - History and current status of the fetoscopic approach.

11:00 h - COFFEE BREAK

11:20 h - Setting of the OR (OR nurse)
11:30 h - Instruments and materials (OR nurse)
11:40 h - Maternal and Fetal anesthesia
12:00 h - Fetoscopic surgery. Step by step. Preparation of cannulas, sutures, and patches.
12:15 h – Maternal laparotomy. Placental mapping and trocar insertion. Amniodistention. Fetal position. 12:30 h – Neurosurgical repair. Important tips and concepts. Skin flaps.
12:45 h – Placement of patches (dural/cutaneous) and skin closure. Uterine access closure.
13:00 h – Intraoperative fetal monitoring. Postnatal management. Tocolysis.
13:15 h – Rest of the pregnancy monitoring, complications and delivery.
13:30 h – Questions and discussion.

14:30 h – LUNCH

15:30 h – Neonatogist management and overview (Dr. Riddle VIRTUAL)
15:45 h – Neurosurgical management of the newborn. Short and long term follow up.
17:00 h – End of day. Relax and walk in Caceres.

21:00 h – DINNER together

Saturday, March 21st

09-11h Practice on the SIMULATOR. Basic technical concepts and steps.

11:00 COFFEE BREAK

11:30 – Demonstration in the animal model (pregnant ewes) – creation SB and Fetoscopic Repair. 11-14h – HANDS-ON: Creation SB + Fetoscopic Repair with dural patch and primary skin closure.

14-15h - Lunch

15-17h – HANDS-ON: Fetoscopic Repair with dural and skin alloderm patch – closure of uterus.
17:00 h – End of the course. Certificates. Farewell.