A tiny robot could soon be performing surgery on unborn babies

Ourselin's team plans to develop a small three-armed robot, no more than 2 cm wide, to allow more surgeries to take place, as part of a $17 million project funded by the Wellcome Trust and Engineering and Physical Sciences Research Council.

The device will consist of a photoacoustic camera that provides 3D imaging of the fetus in real time, which will help guide two flexible arms to deliver gels or patches to seal the gap in the spine of babies with spina bifida. If successful, the arms will be developed with more dexterity and degrees of freedom to perform surgery themselves and treat further conditions such as congenital heart disease. They may even deliver stem cells as stem cell therapies progress. Once entry into the womb becomes safe, the potential is huge.

It will consist of a camera providing 3D images of the fetus, which will help guide two flexible arms in delivering gels or patches to seal the gap in the spine of babies with spina bifida. If successful, the arms will be developed to perform surgery themselves and treat conditions such as congenital heart disease.

Where surgery is available, people are reluctant and fearful of the side-effects
Jan Deprest, KU Leuvin

In countries where fetal surgery is currently performed, surgeons cut into the mother's womb before 26 weeks of pregnancy, but there are health risks, side effects to mothers and risks of pre-term labor.

"Where surgery is available in Europe, people are reluctant and fearful of the side-effects," explains Dr. Jan Duprest, who is leading the work at KU Leuvin and has patients declining surgery quite regularly. "Robotic surgery is becoming popular these days and we need to take advantage of that and improve not only the number of patients choosing surgery but also improve the freedom with which we can operate using these flexible probes."

To have the best effect, surgery must take place before 26 weeks to prevent damage to the exposed spinal cord and the resulting disability. Ourselin wants to go in even earlier.

"We want to go in at 16 weeks to provide the greatest benefit to patients and no one is doing this yet," concludes Ourselin. "The most important thing is to reduce the invasiveness of the procedure as you want to avoid causing pre-term labor. If we can make this possible, we want to expand treatment to be possible for all diseases which are already present at birth."