We have been able to perform, in our sheep model, dual access port fetoscopic neural tube closure using a 12 F cannula, a second 9F cannula, a cover patch, and a medical sealant with similar results to that seen with open fetal surgical repair in the same sheep model.26 Using the knowledge and expertise gained with more than 3 years of experience in fetoscopic sheep surgery, Dr. Peiro has now performed 8 minimally invasive repairs on human patients in Barcelona (Vall D'Hebron Hospital, INPER, Mexico City, Mexico) with members of our team in attendance, and we (Belfort and Shamshirsaz) have performed one fetoscopic evaluation of a fetus using the uterine exposure and CO2 technique which was subsequently converted into an open case because of the size and complexity of the neural tube defect, in Iran.