Intrauterine hematoma evacuation during fetoscopic myelomeningocele repair: a novel application of the NICO Myriad

Evacuating intrauterine hematomas during fetoscopic myelomeningocele repair can be challenging. The NICO Myriad (Stryker Inc.) has been previously described to resect brain tumors, as an adjunct in intraventricular neuroendoscopy, and, most recently, has been proven to effectively remove intracerebral hematomas at clinical and cost-effective significance. This device has not been described in fetal neurosurgery. In this video, the NICO Myriad was utilized during a minilaparotomy fetal myelomeningocele repair to mechanically aspirate an intrauterine hematoma noted at the end of the operation. The surgical technique and technical nuances of using the NICO Myriad during fetoscopic myelomeningocele repair are reviewed. The video can be found here: https://stream.cadmore.media/r10.3171/2026.1.FOCVID25233