Fetal surgery for sacrococcygeal teratoma

A great deal has been learned regarding the natural history and pathophysiology of fetal sacrococcygeal teratoma (SCT). The logic behind fetal intervention for SCT with hydrops appears to be correct, and open and minimal access techniques of fetal intervention have been shown to be feasible. Trends in fetal surgery are moving from open, invasive techniques to minimally invasive techniques, and moving away from total in utero repair of a defect that recapitulates postnatal treatment toward manipulation of fetal pathophysiology to reverse life-threatening events. Further study is required to determine the role of minimal access techniques in SCT. Future directions for treatment of fetal SCT with hydrops might include fetoscopic resection or high-intensity ultrasound ablation.