Fetoscopic surgery is a growing area of interest. John Hopkins Hospital in Baltimore USA is performing laparoscopic fetoscopic repair of spina bifida, in utero surgery to repair spina bifida (see video below). This has shown benefits with regards to urinary and bowel outcomes in this group of children. Currently open fetoscopic surgery is being used in the UK with a corresponding higher risk of early abortion and loss of the pregnancy. Robotic surgery could potentially improve the outcomes further for these babies allowing the benefits of open surgery without the risk to the fetus.
Better alternatives to bowel for bladder augmentation. Currently patients born with conditions leading to very small bladders require expansion using the bowel to protect the kidneys or to achieve continence. Bowel augmentations to expand the bladder have significant complications including tumours, stones and bowel complications. Paediatric Urologists in the UK are developing better alternatives where decellularised cadaveric tissue is vascularised in the omentum prior to being used as a patch to augment the bladder.
ENT surgery for laryngeal clefts is currently done using old fashioned instruments without the wristed movements demonstrated by robotic surgery. The difficulties can be seen in the video below. Robotic surgery platforms can significantly enhance surgery for laryngeal cleft repair and resection of tumours around the base of the tongue.
