New visualization techniques for in utero surgery: amnioscopy with a three-dimensional head-mounted display and a...

Area of Science:

• Minimally Invasive Surgery
• Fetal Medicine
• Surgical Technology

Background:

• Open hysterotomy for fetal surgery risks preterm labor.
• Current visualization technology limits endoscopic fetal surgery.
• Improved imaging is crucial for minimally invasive fetal procedures.

Purpose of the Study:

• To investigate a novel three-dimensional (3D) imaging system with a head-mounted display (HMD) and computer-controlled zoom endoscope for endoscopic fetal surgery.
• To assess the feasibility and benefits of this advanced visualization technology in a preclinical model.

Main Methods:

• A 10-mm computer-controlled zoom endoscope and a 3D-HMD system were utilized in pregnant sheep under general anesthesia.
• Maternal laparoscopy provided uterine access for fetal and umbilical cord inspection and manipulation.
• The system allowed for real-time 3D imaging and facilitated microsurgical tasks.

Main Results:

• The 3D-HMD system provided real-time, enhanced depth perception for detailed fetal and placental examination.
• The computer-controlled zoom endoscope offered excellent visibility and facilitated manipulation of fetal structures.
• Surgeons could adopt a natural operative posture with the adjustable HMD.

Conclusions:

• The developed 3D imaging system and zoom endoscope significantly enhance visualization for endoscopic fetal surgery.
• Improved anatomic detail and appreciation of fetal movements make intrauterine procedures more feasible.
• This technology represents a significant advancement for minimally invasive fetal interventions.