A Needle Lasso Method for Port Site Closure and Amniotic Membrane Plication in Fetoscopic Surgery

Amniotic membrane plication is associated with lower rates of preterm birth following fetoscopy. We describe a novel needle lasso technique for amniotic membrane plication during port site closure in laparotomy- and mini-laparotomy-assisted fetoscopic spina bifida repair. This approach enables precise placement of full-thickness sutures around the port tract, even when direct suturing is technically challenging. We achieved amniotic membrane plication in all the cases, and delivery beyond 34 weeks of gestation without membrane-related complications. These findings support the technique's feasibility. Larger studies are needed to corroborate the results and potentially broaden their application in fetoscopic surgery.