Fetoscopic myelomeningocele repair: standard technique and approaches for closure of large defects

Fetoscopic repair of myelomeningocele (MMC) offers a minimally invasive alternative to open prenatal surgery. This approach protects exposed neural tissue while reducing the need for postnatal CSF diversion and lowering maternal morbidity compared to open techniques. In this video, the authors demonstrate a standardized fetoscopic technique for MMC repair using an externalized uterine approach. Key steps include placode release, excision of transitional epithelium, and multilayer closure with a dural substitute. The authors highlight technical pearls for managing myeloschisis and large MMCs, including relaxing incisions and myofascial mobilization, to achieve a tension-free, watertight repair. The video can be found here: https://stream.cadmore.media/r10.3171/2026.1.FOCVID25226.