This new Australian publication asks the question  in its title that many of us are asking. (Cundy TP, Gardener GJ, Andersen CC, Kirby CP, McBride CA, Teague WJ: Fetoscopic endoluminal tracheal occlusion (feto) for congenital diaphragmatic hernia in australia and new zealand: Are we willing, able, both or neither? Journal of Paediatrics and Child Health 2014).

In case you are wondering, this means doing an amnioscopy, and then doing a tracheoscopy on the fetus to deposit a balloon that occludes the trachea. Not a straightforward procedure! Then in some protocols a second procedure before term to remove the balloon. The article that I cited reviews the literature and notes that there are now 9 reports of various trials including 4 very small RCTs. Recent data show much less prematurity than the older publications, as techniques have evolved. The FETENDO technique does look like there is  a good chance that it decreases mortality in the most severe cases.

In answer to my own question, posed in the title, I don’t think we are ready for widespread adoption, but ongoing studies will be important. I think that perhaps the technique should be available for very high risk cases who are not willing to be randomized, but who will be evaluated prospectively, as an ‘innovative therapy’.