Cesarean Extraction (CE)
Cesarean Extraction is the most widely selected delivery pathway in the MRMP, chosen by approximately 78% of patients in our current cohort. The procedure is a laparoscopic abdominal surgery performed under general anesthesia by our maternal-fetal medicine surgical team, typically lasting 60–90 minutes.
The infant is delivered through three small laparoscopic incisions (5–10mm each) using a combination of robotic-assisted and manual technique. The organoid is removed along with the infant and does not remain in the body after delivery.
| Metric | CE Pathway |
|---|---|
| Average Procedure Time | 65 minutes |
| Hospital Stay | 2–3 nights |
| Major Complication Rate | 3.8% |
| Return to Normal Activity | 4–6 weeks |
| Current Program Selection Rate | ~78% |
CE Eligibility
Most MRMP patients are eligible for CE delivery. Your surgical team will confirm eligibility based on organoid positioning, gestational imaging findings, and your overall clinical status at the time of delivery planning (typically 34–36 weeks gestation).
TAD Eligibility
TAD is available to patients meeting specific anatomical and gestational criteria established by the MRMP surgical committee. Eligibility is assessed at 34 weeks gestation. Approximately 35% of MRMP patients are eligible; of those, about 62% choose this pathway.
Transanal Assisted Delivery (TAD)
The Transanal Assisted Delivery pathway was developed at Harrington University and first performed in 2019. It is a minimally invasive endoscopic procedure performed under general anesthesia by Dr. Ferrara's colorectal and MFM surgical co-team. The procedure typically lasts 45–75 minutes.
TAD combines transanal endoscopic technique with external laparoscopic guidance to achieve delivery without abdominal incision. Because organoid positioning in eligible patients places the gestational sac in proximity to the rectosigmoid region, a carefully guided endoscopic approach allows safe delivery with reduced abdominal wall disruption. The organoid is removed in the same procedure.
The TAD-EXTEND Phase III clinical trial, currently enrolling, is building the definitive safety and outcomes dataset for this pathway. Learn about the trial →
| Metric | TAD Pathway |
|---|---|
| Average Procedure Time | 58 minutes |
| Hospital Stay | 2–3 nights |
| Major Complication Rate | 4.6% |
| Return to Normal Activity | 3–5 weeks |
| Current Program Selection Rate | ~22% of all patients |