Hybrid approach to closure in fetoscopic myelomeningocele repair

Neural tube defects (NTDs) affect 2 in 1000 births worldwide. Myelomeningocele (MMC) represents a severe NTD, often with permanent neurological sequelae. The randomized multicenter Management of Myelomeningocele Study (MOMS) showed that open prenatal (compared to postnatal) myelomeningocele closure could reverse hindbrain herniation, lower rates of shunt insertion for hydrocephalus, and improve neurological function, with the trade-off of increased maternal complications and premature birth. Fetoscopic approaches may have equivalent benefits to open fetal MMC closure with fewer maternal complications. The hybrid approach to fetoscopic repair (primary closure vs biosubstitute patch) described in this video can be tailored to individual fetal anatomy and promote comparable epithelialization over time. The video can be found here: https://stream.cadmore.media/r10.3171/2026.1.FOCVID25222.