Scientists have launched a pounds 10m project to create a tiny surgical robot hand that could transform the treatment of children with spina bifida and other congenital conditions.
The aim of the research, which is being carried out by engineers at
"The aim is to create less invasive surgical technologies to treat a wide range of diseases in the womb, with considerably less risk to both mother and baby," said the project leader, Professor
A prime priority for the project, which is being funded by the
Such surgery involves opening the mother's abdomen and uterus and incurs a significant risk of triggering premature birth, however. As a result, operations like these are rarely carried out. "They are very dangerous," said project manager
In addition, surgery on the unborn can only be carried out when the foetus is at least 26 weeks old. By that time, considerable damage may already have been done to the child's growing brain. "We need to find a way to block up the gap in the baby's spine at a much earlier stage in the foetus's development," added Ourselin. "Ideally, it should be done around 16 weeks. The earlier the treatment, the more effective it will be."
At present, such operations are impossible. The objective of the Wellcome-funded project is to develop instruments - based on the latest developments in optics and robotics - that will make them possible.
The engineers and doctors involved in the project envisage developing a very thin, highly flexible probe that would be inserted into the womb of a woman carrying a child with spina bifida. The head of the probe would have one strand fitted with a tiny camera that would use laser pulses and ultrasound detection - a combination known as photo-acoustic imaging - to generate a 3D photograph inside the womb. These images would then be used by the surgeons to guide the probe to its target: the gap in the foetus's spine.
The probe's other arms would also be fitted with tiny instruments which would carry a piece of gel or patch that would then be inserted over the gap in the baby's spine. "It will be like a plaster," added Ourselin. "If we can do that, there will massive gain for the foetus while there will be little risk to the mother."
At present, most designs for the robot foetal surgeon envisage a three-pronged device that has one arm fitted with a camera and two that are fitted with pincers or other instruments.
"We are still in the design stage, so we could end up with a device with four or five arms in the end," added Ourselin. "Nor would it be used merely to put in patches. It could carry out delicate surgery or deliver stem cells to damaged organs."
In addition to the spina bifida cases, the device could also help in the treatment of many other foetal conditions, such as twin-to-twin-transfusion-syndrome (TTTS) in which there is an unequal, life-threatening supply of blood twins inside the womb.
"Operating on babies in the womb should not be undertaken lightly," added Ourselin. "We need the very best surgical tools to do something like this, and this project will make sure we have them in the next few years."
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