OP08.09: Operative technical complications during fetal endoscopic tracheal occlusion for congenital diaphragmatic hernia

To describe the frequency of technical complications during fetal endoscopic tracheal occlusion (FETO) for fetuses with congenital diaphragmatic hernia (CDH). A retrospective cohort study was conducted among consecutive fetuses with left-sided CDH treated with FETO in a single fetal surgery centre in Mexico from January 2012 to February 2024. The types, incidence and related factors of operative technical complications during FETO were analysed. Eighty-one CDH fetuses treated with FETO were included. Endotracheal placement of the balloon was performed successfully in all cases at a mean GA of 29.6 (SD 1.3). Access into the fetal trachea was achieved in the first attempt in up to 88.8%. Twelve (14.8%) cases showed operative technical complications during FETO. Fetoscope dislodgement out of the trachea before balloon deployment in 5 (6.2%), internal version of the fetal presentation during tracheoscopy in 3 (3.7%), rupture of the catheter during balloon detachment in 2 cases (2.5%), balloon rupture in 1 (1.2%), need to re-position the fetoscope by re-entering the uterine cavity in 1 (1.2%). FETO may be feasible in all cases but intraoperative technical complications can be expected in up to 15% of them.