Minimal invasive novel devices for advanced intrauterine fetal surgery

Abstract

For advanced intrauterine fetal surgery, we have developed novel devices as "new hand" and "new eye".As new hands, we developed a miniature bending manipulator with exchangeable distal-end effector of laser photocoagulation and forceps for safe approach and optimal procedure of intrauterine myelomeningocele repair and twin-to-twin transfusion syndrome. The manipulator performed high bending accuracy with a minimal error of 0.1 mm. In laser photocoagulation test, we confirmed ablation of underwater chicken liver surface successfully. As a new eye, we developed novel navigation system for safe and secure guidance of the high-intensity focused ultrasound (HIFU) to correct cardiac morphologic abnormalities such as hypoplastic left heart syndrome. In in vivo evaluation using beating heart of four anesthetized adult rabbits, the system successfully achieved a non-touch gross ablation and small transmural opening of the atrial septum. For future works, we will introduce new eye that is navigation system combined with a small 3D endoscope or 3D/4D ultrasound.