# A novel smart patch for the fetoscopic procedure to repair spina bifida

> **NIH NIH R01** · UNIVERSITY OF CINCINNATI · 2020 · $511,369

## Abstract

Project Summary (Abstract)
Open spina bifida or myelomeningocele (MMC) is a devastating neurologic congenital defect characterized by
primary failure of neural tube closure of the spinal column during the embryologic period. Cerebrospinal fluid
(CSF) leak caused by MMC in the developing fetus can result in a constellation of anomalies that include
hindbrain herniation and brain-stem abnormalities. The exposure of extruded spinal cord to amniotic fluid also
poses a significant risk for inducing partial or complete paralysis of the body parts beneath the spinal aperture. A
recent randomized trial demonstrated that open fetal surgery is effective in reducing the postnatal neurologic
morbidity, as evidenced by decreased incidence and severity of postnatal hydrocephalus and reduced need for
postnatal ventricular-peritoneal shunting. However, as open fetal surgery has been noticed to be associated with
increased potential for maternal-fetal morbidities, innovative minimally invasive fetoscopic techniques to repair
MMC are receiving growing attentions for their less invasiveness. Nonetheless, deploying patches through small
trocar ports and unfolding patches for defect coverage can be extremely cumbersome and thus uncontrollably
prolongs the surgical duration. Moreover, inert patches necessitate postnatal removal surgeries, which lead to
higher surgical costs and psychological trauma to the infant and parents. The long-term effectiveness for some
mesh-like patches to barrier the defect is also debating. There is an enormous need to obtain a “smart” patch that
is self-expanding, impermeable to cease the CSF leaking and biodegradable to accommodate the scheme of
wound healing. Recently we have attempted to develop such a “smart patch” for the fetoscopic procedure to
repair MMC that hopefully addresses all the hurdles aforementioned concurrently. By blending two polymers that
have been utilized in fabricating biodegradable spinal implants, we developed a new patch made with
poly(ε-caprolactone) (PCL) and poly(L-lactide) that possesses desired characteristics of shape retention,
water-tightness, biocompatibility, affinity for cellular attachment, and biodegradation. The goal of the current
project is to assess how the features of the newly designed patch can contribute to the protection of affected
spinal cord that in turn alleviates complications associated with MMC defect. Using a sheep MMC model we have
developed, we would like to further assess the efficacies of the new PLA/PCL patch in: (1) reducing the
procedure time of fetoscopic coverage on MMC, (2) providing adequate barrier to stop CSF leak and protect the
exposed spinal cord to mitigate the damage, which will help preserve and even improve the affected motor
function, and (3) guiding and enhancing wound closure of MMC without tethering the spinal cord as our defined
aims. If successful, our designed new patch will help advance fetoscopic approaches to become the most reliant
procedure for the pre...

## Key facts

- **NIH application ID:** 9875484
- **Project number:** 5R01NS103992-02
- **Recipient organization:** UNIVERSITY OF CINCINNATI
- **Principal Investigator:** Chia-Ying James Lin
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $511,369
- **Award type:** 5
- **Project period:** 2019-04-01 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9875484

## Citation

> US National Institutes of Health, RePORTER application 9875484, A novel smart patch for the fetoscopic procedure to repair spina bifida (5R01NS103992-02). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/9875484. Licensed CC0.

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