Objectives: Fetal repair of myelomeningocele carries indubitable benefits for kids, but is also associated with an increased risk of complications. Most of these complications, like premature rupture of membranes, preterm delivery or mandatory cesarean section after open fetal repair, occur due to the hysterotomy. Endoscopic fetal repair of myelomeningocele has the potential to reduce most of these complications while maintaining the benefits of prenatal repair.

Methods: We describe a novel technique for endoscopic fetal repair of myelomeningocele through only two ports, achieving a complete primary closure of the defect without the need for dura or skin substitutes.

Results: We present an illustrative video that describes the novel technique for endoscopic fetal repair of myelomeningocele developed in our center. To date this procedure has been performed on 12 patients, resulting in 41.66% vaginal delivery rate and mean gestational age at delivery of 36.49 week. To date, these outcomes illustrate a significant improvement compared to the results already published in classic open repair through hysterotomy.

Conclusions: The novel technique we present, endoscopic fetal repair of myelomeningocele through two ports, can be considered an alternative to the classic open closure through hysterotomy.