{"id":623,"date":"2026-08-14T12:19:55","date_gmt":"2026-08-14T12:19:55","guid":{"rendered":"https:\/\/dev.muraridev.com.br\/denise\/?page_id=623"},"modified":"2026-08-20T21:09:28","modified_gmt":"2026-08-20T21:09:28","slug":"tecnica-safer","status":"publish","type":"page","link":"https:\/\/dev.muraridev.com.br\/denise\/tecnica-safer\/","title":{"rendered":"T\u00e9cnica Safer"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"623\" class=\"elementor elementor-623\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-d14b491 e-flex e-con-boxed e-con e-parent\" data-id=\"d14b491\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-1688bca elementor-widget__width-initial elementor-widget-mobile__width-auto elementor-widget elementor-widget-heading\" data-id=\"1688bca\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\"> T\u00e9cnica<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d3714c5 elementor-widget__width-initial elementor-widget-mobile__width-inherit elementor-widget elementor-widget-heading\" data-id=\"d3714c5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\"> SAFER<\/h2>\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-c255da2 e-flex e-con-boxed e-con e-parent\" data-id=\"c255da2\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-9f8c118 e-con-full e-flex e-con e-child\" data-id=\"9f8c118\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-c5ae09f elementor-widget elementor-widget-heading\" data-id=\"c5ae09f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Defini\u00e7\u00e3o e <\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-eb318eb elementor-widget elementor-widget-heading\" data-id=\"eb318eb\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Origem<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-fb9cc6d elementor-hidden-desktop elementor-widget elementor-widget-image\" data-id=\"fb9cc6d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"300\" height=\"247\" src=\"https:\/\/dev.muraridev.com.br\/denise\/wp-content\/uploads\/2026\/08\/Rectangle-183-e1786714491432.png\" class=\"attachment-full size-full wp-image-683\" alt=\"\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0003168 elementor-widget__width-initial elementor-widget-mobile__width-inherit elementor-widget elementor-widget-text-editor\" data-id=\"0003168\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>A T\u00e9cnica SAFER (Skin-over-biocellulose for the Antenatal Fetoscopic Repair of myelomeningocele) \u00e9 um <strong>procedimento cir\u00fargico fetal minimamente invasivo, percut\u00e2neo, desenvolvido e aprimorado ao longo de mais de duas d\u00e9cadas<\/strong> de pesquisa experimental e cl\u00ednica no Brasil pela Dra. Denise Ara\u00fajo Lapa.<\/p><p>O nome da t\u00e9cnica descreve seus dois elementos fundamentais: a abordagem fetosc\u00f3pica (sem abertura do abdome materno) e o uso de um patch de biocelulose como que vai estimular o pr\u00f3prio feto a formar a camada que faltava que \u00e9 a duramater. Esses dois elementos, combinados, diferenciam a SAFER de todas as outras abordagens dispon\u00edveis e explicam seus resultados superiores.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-658e87d e-con-full e-flex e-con e-child\" data-id=\"658e87d\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-cd6f654 elementor-hidden-desktop elementor-widget elementor-widget-image\" data-id=\"cd6f654\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"308\" height=\"269\" src=\"https:\/\/dev.muraridev.com.br\/denise\/wp-content\/uploads\/2026\/08\/Rectangle-232-e1786714521177.png\" class=\"attachment-full size-full wp-image-684\" alt=\"\" srcset=\"https:\/\/dev.muraridev.com.br\/denise\/wp-content\/uploads\/2026\/08\/Rectangle-232-e1786714521177.png 308w, https:\/\/dev.muraridev.com.br\/denise\/wp-content\/uploads\/2026\/08\/Rectangle-232-e1786714521177-300x262.png 300w\" sizes=\"(max-width: 308px) 100vw, 308px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0d3c948 elementor-hidden-tablet elementor-hidden-mobile elementor-widget elementor-widget-image\" data-id=\"0d3c948\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"448\" height=\"377\" src=\"https:\/\/dev.muraridev.com.br\/denise\/wp-content\/uploads\/2026\/08\/Group-67-1.png\" class=\"attachment-full size-full wp-image-635\" alt=\"\" srcset=\"https:\/\/dev.muraridev.com.br\/denise\/wp-content\/uploads\/2026\/08\/Group-67-1.png 448w, https:\/\/dev.muraridev.com.br\/denise\/wp-content\/uploads\/2026\/08\/Group-67-1-300x252.png 300w\" sizes=\"(max-width: 448px) 100vw, 448px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-17e2078 elementor-widget__width-initial elementor-widget-mobile__width-inherit elementor-widget elementor-widget-text-editor\" data-id=\"17e2078\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Foram necess\u00e1rios anos de pesquisa experimental em modelos ovinos para refinar cada etapa do procedimento antes de sua aplica\u00e7\u00e3o cl\u00ednica. O primeiro caso humano foi realizado em 2013. A t\u00e9cnica foi consolidada e publicada internacionalmente a partir de 2016, e declarada n\u00e3o mais experimental ap\u00f3s a publica\u00e7\u00e3o sistem\u00e1tica de seus resultados em 2021.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-4b57ae9 e-flex e-con-boxed e-con e-parent\" data-id=\"4b57ae9\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-d1daed2 e-con-full e-flex e-con e-child\" data-id=\"d1daed2\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-1a9090e elementor-widget__width-inherit elementor-widget elementor-widget-heading\" data-id=\"1a9090e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Os 7 Passos do <\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-846ceb0 elementor-widget__width-inherit elementor-widget elementor-widget-heading\" data-id=\"846ceb0\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Procedimento<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-244532e e-flex e-con-boxed e-con e-parent\" data-id=\"244532e\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-559454c e-con-full e-flex e-con e-child\" data-id=\"559454c\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-05b2aae elementor-widget__width-initial elementor-widget elementor-widget-heading\" data-id=\"05b2aae\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">01<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3f78a2d elementor-widget__width-auto elementor-widget elementor-widget-text-editor\" data-id=\"3f78a2d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><strong>Acesso percut\u00e2neo guiado por ultrassom.<\/strong><br \/>Sob anestesia geral materna e monitoramento cont\u00ednuo da vitalidade fetal, tres ou quatro trocateres de pequeno calibre s\u00e3o inseridos atrav\u00e9s da parede abdominal materna, em dire\u00e7\u00e3o ao \u00fatero sob orienta\u00e7\u00e3o ultrassonogr\u00e1fica em tempo real. Nenhum corte no abdome materno \u00e9 necess\u00e1rio.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-a0b8655 e-con-full e-flex e-con e-child\" data-id=\"a0b8655\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-d27b69e elementor-widget__width-initial elementor-widget elementor-widget-heading\" data-id=\"d27b69e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">02<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-61f6b52 elementor-widget__width-auto elementor-widget elementor-widget-text-editor\" data-id=\"61f6b52\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><strong>Substitui\u00e7\u00e3o do l\u00edquido amni\u00f3tico por CO\u2082 umidificado e aquecido.<\/strong> O l\u00edquido amni\u00f3tico \u00e9 parcialmente drenado e substitu\u00eddo por di\u00f3xido de carbono umidificado a 37\u00b0C. Esse ambiente a\u00e9reo dentro do \u00fatero melhora a visibilidade endosc\u00f3pica e permite o uso de instrumentos cir\u00fargicos convencionais.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-693eec6 e-con-full e-flex e-con e-child\" data-id=\"693eec6\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-39bcb6a elementor-widget__width-initial elementor-widget elementor-widget-heading\" data-id=\"39bcb6a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">03<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-91aad50 elementor-widget__width-auto elementor-widget elementor-widget-text-editor\" data-id=\"91aad50\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><strong>Dissec\u00e7\u00e3o completa e mobiliza\u00e7\u00e3o do plac\u00f3dio neural.<\/strong> Com aux\u00edlio de microc\u00e2mera e instrumentos cir\u00fargicos, o plac\u00f3dio neural \u2014 a por\u00e7\u00e3o exposta da medula \u2014 \u00e9 cuidadosamente dissecado e liberado dos tecidos ectod\u00e9rmicos ao redor, reposicionado dentro do canal espinhal.\u00a0<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-9a9846f e-con-full e-flex e-con e-child\" data-id=\"9a9846f\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2798a16 elementor-widget__width-initial elementor-widget elementor-widget-heading\" data-id=\"2798a16\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">04<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-116a172 elementor-widget__width-auto elementor-widget elementor-widget-text-editor\" data-id=\"116a172\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><strong>Aplica\u00e7\u00e3o do patch de biocelulose.<\/strong> Um patch de biocelulose, dimensionado para cada defeito, \u00e9 posicionado sobre o plac\u00f3dio. A biocelulose atua como substituto tempor\u00e1rio da dura-m\u00e1ter e como matriz indutora para a forma\u00e7\u00e3o de uma neo-duram\u00e1ter. Ao n\u00e3o suturar diretamente a dura-m\u00e1ter, evita-se a forma\u00e7\u00e3o do tecido cicatricial que seria respons\u00e1vel pela s\u00edndrome da medula presa, na fase de crescimento da crian\u00e7a.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-7692d77 e-con-full e-flex e-con e-child\" data-id=\"7692d77\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f708c62 elementor-widget__width-initial elementor-widget elementor-widget-heading\" data-id=\"f708c62\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">05<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-bf281da elementor-widget__width-auto elementor-widget elementor-widget-text-editor\" data-id=\"bf281da\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><strong>Fechamento do m\u00fasculo e aponeurose.<\/strong> Um retalho miofascial \u00e9 \u201crodado\u201d sobre o patch de biocelulose, evitando comprimir externamente o plac\u00f3dio. Esse plano \u00e9 suturado na linha m\u00e9dia<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-a9d3c6b e-con-full e-flex e-con e-child\" data-id=\"a9d3c6b\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-c52b8b7 elementor-widget__width-initial elementor-widget elementor-widget-heading\" data-id=\"c52b8b7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">06<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3848ddd elementor-widget__width-auto elementor-widget elementor-widget-text-editor\" data-id=\"3848ddd\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><strong>Sutura da pele.<\/strong> A pele do feto \u00e9 suturada na linha m\u00e9dia, fechando completamente o defeito, o beb\u00ea nasce com a regi\u00e3o cicatrizada. Quando n\u00e3o h\u00e1 pele suficiente para cobrir toda a les\u00e3o, utilizamos uma pele artificial para evitar, incis\u00f5es de relaxamento que muitas vezes s\u00e3o utilizadas por outros autores para permitir o fechamento da pele.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-647781d e-con-full e-flex e-con e-child\" data-id=\"647781d\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f2cafc9 elementor-widget__width-initial elementor-widget-mobile__width-auto elementor-widget elementor-widget-heading\" data-id=\"f2cafc9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">07<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a7c8161 elementor-widget__width-inherit elementor-widget elementor-widget-text-editor\" data-id=\"a7c8161\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><strong>Restaura\u00e7\u00e3o do l\u00edquido amni\u00f3tico e retirada dos trocateres.<\/strong> Concomitante a elimina\u00e7\u00e3o do CO\u2082 o l\u00edquido amni\u00f3tico vai sendo reintroduzido. Os trocateres s\u00e3o retirados com controle ultra-sonogr\u00e1fico e; os pequenos orif\u00edcios no \u00fatero se fecham espontaneamente pela contra\u00e7\u00e3o miometrial normal. Apenas a pele materna \u00e9 suturada.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-d532398 e-flex e-con-boxed e-con e-parent\" data-id=\"d532398\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-fb57411 e-con-full e-flex e-con e-child\" data-id=\"fb57411\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-68afe61 elementor-widget elementor-widget-heading\" data-id=\"68afe61\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">O Grande Diferencial da <\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f93d22e elementor-widget elementor-widget-heading\" data-id=\"f93d22e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Biocelulose<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9cac0d5 elementor-widget__width-initial elementor-widget-mobile__width-inherit elementor-widget elementor-widget-text-editor\" data-id=\"9cac0d5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>A biocelulose (celulose bacteriana ou celulose biossint\u00e9tica) \u00e9 um <strong>biomaterial produzido por bact\u00e9rias do g\u00eanero acinetobacter, com estrutura de nanofibras de celulose pura altamente hidratada.<\/strong> Sua microestrutura tridimensional \u00e9 muito semelhante \u00e0 do col\u00e1geno humano, conferindo excelente biocompatibilidade.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-5184b85 e-con-full e-flex e-con e-child\" data-id=\"5184b85\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-ade5962 elementor-hidden-tablet elementor-hidden-mobile elementor-widget elementor-widget-image\" data-id=\"ade5962\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"441\" height=\"410\" src=\"https:\/\/dev.muraridev.com.br\/denise\/wp-content\/uploads\/2026\/08\/Group-68.png\" class=\"attachment-full size-full wp-image-657\" alt=\"\" srcset=\"https:\/\/dev.muraridev.com.br\/denise\/wp-content\/uploads\/2026\/08\/Group-68.png 441w, https:\/\/dev.muraridev.com.br\/denise\/wp-content\/uploads\/2026\/08\/Group-68-300x279.png 300w\" sizes=\"(max-width: 441px) 100vw, 441px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-4da12b0 e-con-full e-flex e-con e-child\" data-id=\"4da12b0\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-8efd08c elementor-widget__width-initial elementor-widget-mobile__width-inherit elementor-widget elementor-widget-text-editor\" data-id=\"8efd08c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Estudos histol\u00f3gicos realizados em modelos animais documentaram a forma\u00e7\u00e3o de uma <strong>neo-duram\u00e1ter organizada,<\/strong> com arquitetura semelhante \u00e0 dura-m\u00e1ter original, nos casos em que a biocelulose foi utilizada. A compara\u00e7\u00e3o com os casos em que a biocelulose n\u00e3o foi utilizada, e o defeito foi fechado usando a t\u00e9cnica neurocir\u00fargica cl\u00e1ssica (tres planos de sutura) tiveram resultados muito inferiores, com menor preserva\u00e7\u00e3o neuronal e ader\u00eancia entre os tecidos suturados.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-db610a4 e-flex e-con-boxed e-con e-parent\" data-id=\"db610a4\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-01414e4 e-con-full e-flex e-con e-child\" data-id=\"01414e4\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-ff99a8a elementor-widget__width-inherit elementor-widget elementor-widget-heading\" data-id=\"ff99a8a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Os 7 Passos do <\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e43c1bd elementor-widget__width-inherit elementor-widget elementor-widget-heading\" data-id=\"e43c1bd\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\"><span style=\"color: #374B8A\">Compara\u00e7\u00e3o<\/span> com as\nDemais T\u00e9cnicas<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9101827 elementor-widget__width-initial elementor-widget elementor-widget-html\" data-id=\"9101827\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t\t<style>\r\n  .tabela-safer-wrapper {\r\n    width: 100%;\r\n    overflow-x: auto;\r\n  }\r\n\r\n  .tabela-safer {\r\n    width: 100%;\r\n    border-collapse: collapse;\r\n    font-family: Arial, sans-serif;\r\n    font-size: 20px;\r\n    color: #333;\r\n    table-layout: fixed;\r\n  }\r\n\r\n  .tabela-safer th {\r\n    background-color: #aeb6ca;\r\n    color: #111;\r\n    font-weight: 700;\r\n    padding: 18px 12px;\r\n    text-align: center;\r\n    border: 1px solid #8793ad;\r\n    line-height: 1.5;\r\n  }\r\n\r\n  .tabela-safer td {\r\n    background-color: #f1f1f1;\r\n    padding: 11px 10px;\r\n    text-align: center;\r\n    vertical-align: middle;\r\n    border: 1px solid #aeb6ca;\r\n    line-height: 1.5;\r\n  }\r\n\r\n  .tabela-safer th:first-child,\r\n  .tabela-safer td:first-child {\r\n    width: 35%;\r\n  }\r\n\r\n  .tabela-safer th:nth-child(2),\r\n  .tabela-safer td:nth-child(2),\r\n  .tabela-safer th:nth-child(3),\r\n  .tabela-safer td:nth-child(3) {\r\n    width: 32.5%;\r\n  }\r\n\r\n  @media (max-width: 767px) {\r\n    .tabela-safer {\r\n      min-width: 650px;\r\n      font-size: 15px;\r\n    }\r\n\r\n    .tabela-safer th {\r\n      padding: 15px 10px;\r\n    }\r\n\r\n    .tabela-safer td {\r\n      padding: 10px 8px;\r\n    }\r\n  }\r\n<\/style>\r\n\r\n<div class=\"tabela-safer-wrapper\">\r\n  <table class=\"tabela-safer\">\r\n    <thead>\r\n      <tr>\r\n        <th>Caracter\u00edstica<\/th>\r\n        <th>T\u00e9cnica Aberta (MOMS)<\/th>\r\n        <th>T\u00e9cnica SAFER<\/th>\r\n      <\/tr>\r\n    <\/thead>\r\n\r\n    <tbody>\r\n      <tr>\r\n        <td>Incis\u00e3o materna<\/td>\r\n        <td>Laparotomia + histerotomia<\/td>\r\n        <td>4 furos percut\u00e2neos<\/td>\r\n      <\/tr>\r\n\r\n      <tr>\r\n        <td>Abertura do \u00fatero<\/td>\r\n        <td>Sim \u2013 cicatriz sempre<\/td>\r\n        <td>N\u00e3o<\/td>\r\n      <\/tr>\r\n\r\n      <tr>\r\n        <td>Risco de ruptura uterina<\/td>\r\n        <td>9% em gesta\u00e7\u00f5es futuras<\/td>\r\n        <td>N\u00e3o ocorre<\/td>\r\n      <\/tr>\r\n\r\n      <tr>\r\n        <td>Parto vaginal<\/td>\r\n        <td>Proibido permanentemente<\/td>\r\n        <td>Permitido em todas as gesta\u00e7\u00f5es<\/td>\r\n      <\/tr>\r\n\r\n      <tr>\r\n        <td>Intervalo para nova gesta\u00e7\u00e3o<\/td>\r\n        <td>2 anos obrigat\u00f3rios<\/td>\r\n        <td>Sem restri\u00e7\u00e3o especial<\/td>\r\n      <\/tr>\r\n\r\n      <tr>\r\n        <td>Fechamento da dura-m\u00e1ter<\/td>\r\n        <td>Sutura prim\u00e1ria<\/td>\r\n        <td>Patch de biocelulose<\/td>\r\n      <\/tr>\r\n\r\n      <tr>\r\n        <td>Neo-duram\u00e1ter<\/td>\r\n        <td>N\u00e3o<\/td>\r\n        <td>Sim \u2013 induzida pela biocelulose<\/td>\r\n      <\/tr>\r\n\r\n      <tr>\r\n        <td>Crian\u00e7as andando<br>(30 meses)<\/td>\r\n        <td>42%<\/td>\r\n        <td>49%<\/td>\r\n      <\/tr>\r\n\r\n      <tr>\r\n        <td>Taxa de medula presa<br>(5 anos)<\/td>\r\n        <td>27%<\/td>\r\n        <td>11%<\/td>\r\n      <\/tr>\r\n\r\n      <tr>\r\n        <td>Crian\u00e7as andando<br>sem aux\u00edlio (5 anos)<\/td>\r\n        <td>Reduz (medula presa 11%)<\/td>\r\n        <td>60% \u2013 aumenta<\/td>\r\n      <\/tr>\r\n\r\n      <tr>\r\n        <td>Revers\u00e3o do Chiari<\/td>\r\n        <td>64%<\/td>\r\n        <td>82%<\/td>\r\n      <\/tr>\r\n\r\n      <tr>\r\n        <td>Re-opera\u00e7\u00e3o ao nascer<\/td>\r\n        <td>Rara<\/td>\r\n        <td>Rara<\/td>\r\n      <\/tr>\r\n\r\n      <tr>\r\n        <td>Permite operar g\u00eameos<\/td>\r\n        <td>N\u00e3o<\/td>\r\n        <td>Sim<\/td>\r\n      <\/tr>\r\n    <\/tbody>\r\n  <\/table>\r\n<\/div>\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-6159e67 e-flex e-con-boxed e-con e-parent\" data-id=\"6159e67\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-65d2779 elementor-widget__width-inherit elementor-widget elementor-widget-heading\" data-id=\"65d2779\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Resultados<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5ea0fbb elementor-widget__width-inherit elementor-widget elementor-widget-heading\" data-id=\"5ea0fbb\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Publicados<\/h2>\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-c0bab65 e-con-full e-flex e-con e-child\" data-id=\"c0bab65\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-d1f439a e-con-full efeito-vidro e-flex e-con e-child\" data-id=\"d1f439a\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-17fcc79 elementor-widget elementor-widget-text-editor\" data-id=\"17fcc79\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><strong>Deambula\u00e7\u00e3o independente:<\/strong> 49% das crian\u00e7as andam independentemente aos 30 meses, aumentando para 60% aos 5 anos \u2014 resultado oposto ao estudo MOMS, onde, a partir dos 5 anos de idade, a taxa diminuiu para 39% devido \u00e0 medula presa.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-8b6d17f e-con-full efeito-vidro e-flex e-con e-child\" data-id=\"8b6d17f\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-3254b6a elementor-widget elementor-widget-text-editor\" data-id=\"3254b6a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><strong>Necessidade de DVP:<\/strong> 31% inferior \u00e0 obtida no estudo MOMS de 40%.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-6c45f67 e-con-full efeito-vidro e-flex e-con e-child\" data-id=\"6c45f67\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-9bb8c2b elementor-widget elementor-widget-text-editor\" data-id=\"9bb8c2b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><strong>Medula presa:<\/strong> 11% vs. 27% no estudo MOMS \u2014 quase tres vezes menor<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-e6ff35e e-con-full efeito-vidro e-flex e-con e-child\" data-id=\"e6ff35e\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-a9c1e26 elementor-widget elementor-widget-text-editor\" data-id=\"a9c1e26\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><strong>Bexiga neurog\u00eanica:<\/strong> 51% dos casos n\u00e3o necessitam de cateterismo intermitente, no MOMS em 62%.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-38c50a3 e-con-full efeito-vidro e-flex e-con e-child\" data-id=\"38c50a3\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-a09c19e elementor-widget elementor-widget-text-editor\" data-id=\"a09c19e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><strong>Revers\u00e3o do Chiari II:<\/strong> em cerca de 82% dos casos, maior que 64% do MOMS.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-f33f1b1 e-con-full efeito-vidro e-flex e-con e-child\" data-id=\"f33f1b1\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4d960aa elementor-widget elementor-widget-text-editor\" data-id=\"4d960aa\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><strong>G\u00eameos:<\/strong> a T\u00e9cnica SAFER j\u00e1 foi realizada com sucesso em gesta\u00e7\u00f5es gemelares.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-8ac9552 e-con-full e-flex e-con e-child\" data-id=\"8ac9552\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-7d6893c elementor-widget elementor-widget-text-editor\" data-id=\"7d6893c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Desde janeiro de 2021, com a publica\u00e7\u00e3o dos primeiros 100 casos com seguimento sistem\u00e1tico, a T\u00e9cnica SAFER deixou de ser classificada como experimental. Essa reclassifica\u00e7\u00e3o foi baseada em n\u00famero suficiente de casos, publica\u00e7\u00e3o em peri\u00f3dicos revisados por pares e ado\u00e7\u00e3o por m\u00faltiplos centros independentes ao redor do mundo.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>T\u00e9cnica SAFER Defini\u00e7\u00e3o e Origem A T\u00e9cnica SAFER (Skin-over-biocellulose for the Antenatal Fetoscopic Repair of myelomeningocele) \u00e9 um procedimento cir\u00fargico fetal minimamente invasivo, percut\u00e2neo, desenvolvido e aprimorado ao longo de mais de duas d\u00e9cadas de pesquisa experimental e cl\u00ednica no Brasil pela Dra. Denise Ara\u00fajo Lapa. O nome da t\u00e9cnica descreve seus dois elementos fundamentais: [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"footnotes":""},"class_list":["post-623","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/dev.muraridev.com.br\/denise\/wp-json\/wp\/v2\/pages\/623","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dev.muraridev.com.br\/denise\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dev.muraridev.com.br\/denise\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dev.muraridev.com.br\/denise\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/dev.muraridev.com.br\/denise\/wp-json\/wp\/v2\/comments?post=623"}],"version-history":[{"count":52,"href":"https:\/\/dev.muraridev.com.br\/denise\/wp-json\/wp\/v2\/pages\/623\/revisions"}],"predecessor-version":[{"id":1200,"href":"https:\/\/dev.muraridev.com.br\/denise\/wp-json\/wp\/v2\/pages\/623\/revisions\/1200"}],"wp:attachment":[{"href":"https:\/\/dev.muraridev.com.br\/denise\/wp-json\/wp\/v2\/media?parent=623"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}