New sealing system as a surgical tecnique to avoid the iatrogenic Preterm Premature Rupture of fetal Membranes (iPPROM)


Febas Bosomba, Germán  


This thesis is focused on the creation of a sealing system that blocks the orifices of the chorioamniotic membrane produced by minimally invasive surgical instruments during fetal operations. Currently, with the improvement of imaging techniques for fetal diagnosis used to monitor pregnancy, the detection of fetal anomalies has increased. In this scenario, it is essential to develop surgical procedures to directly access the fetus in a safer manner. Over the past few years, the use of fetoscopy has provided lees invasive surgical procedures. Fetoscopy is a technique in which, by inserting a trocar through the abdominal cavity, we are able to introduce the necessary instruments to perform the corresponding fetal surgery. Even so, the access to the fetus from a single point limits the possibilities of the technique, as opposed to having access from several points, since it would allow the fetus to be approached from several axes.   One of the problems associated with fetal surgeries is the remaining presence of the orifice in the chorioamniotic membrane once the trocar is removed. The permanence of the orifice, especially in the first hours after surgery, can cause different pathologies: oligohydramnios, chorioamnionitis, pulmonary hypoplasia of the fetus, etc., and also the rupture of the chorioamniotic membrane, which could result in fetal death. This rupture of the membrane is called iatrogenic preterm preterm premature rupture of membranes (iPPROM) and is one of the most common complications during pregnancy. The aim of this work is to create a patch that allows the sealing of these orifices and significantly reduces the leakage of amniotic liquid and the risk of chorioamniotic membrane rupture during the first days after fetoscopy. The development of the sealing system has been divided into three parts, which experiments, advances and results have been obtained in a semi-parallel process until a final medical device was obtained: on the one hand, the development of an adhesive with bioadhesive properties in a wet environment, which is activated when it comes into contact with the amniotic fluid itself; on the other hand, the substrate where the adhesive will be placed and which acts as a patch; and finally, an insertion system that allows the placement of this patch as quickly and safely as possible by the medical team involved in the surgery.




Borrós Gómez, Salvador 


IQS SE - Bioenginyeria

Date of defense