Minimal access surgery has had resounding impact in the practice of surgery. The advantages include less scarring, quick recovery and return to work. It is not surprising that this field has received attention in the practice of fetal surgery as clinicians were faced with considerable complications inherent in open surgical procedures. The field has evolved, skills refined and technology improved, allowing management of selected fetal conditions through minimal access into the uterine cavity and the fetus. There is however, challenges that needs to be addressed. Open surgery cannot be relegated to history books at this stage and the two approaches have specific indications and are complementary.
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