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British Baby Receives Experimental In‑Womb Repair for Severe Gastroschisis

Surgeons in an international trial used minimally invasive fetoscopic access and a preoperative fetal Botox injection to return exposed intestines to the unborn baby's abdomen, and wider use will hinge on trial results

Overview

  • Doctors detected complex gastroschisis during a routine 20‑week scan and referred the expectant mother into an international feasibility trial involving Great Ormond Street, KU Leuven and Texas Children's Hospital.
  • As part of preparation at Leuven, clinicians injected Botox into the fetal abdominal wall to relax muscles before a minimally invasive fetoscopic operation was performed at about 26 weeks by Dr Michael Belfort's team in Houston.
  • During the operation surgeons briefly drained amniotic fluid, insufflated the uterus with carbon dioxide to create working space, returned the exposed bowel into the abdomen and repaired the abdominal wall while the fetus remained in the womb.
  • The baby, Theo, continued to term, was born in February, began breastfeeding soon after birth and was discharged within days, with clinicians reporting no perioperative complications in this single case.
  • Investigators say the procedure remains experimental and that larger trial results and longer follow‑up are needed before the technique could be offered more widely in the UK; if successful it could reduce neonatal operations and prolonged neonatal intensive care for severe cases.