£10 million award for foetal surgery research 

11/06/2014 00:00 
Paediatric surgeons and doctors from UCLH will benefit from a £10 million award from the Wellcome Trust and the Engineering and Physical Science Research Council (EPSRC) to develop better tools, imaging techniques and therapies in future operations on unborn babies.

The research will involve researchers from the National Institute for Health Research University College London Hospitals Biomedical Research Centre (BRC).

BRC-supported Professor Sebastien Ourselin from the UCL Centre for Medical Image Computing will work with engineers at UCL and KU Leuven in Belgium, to develop novel imaging techniques that can be used before and during surgery to visualise blood circulation. It will enable surgeons to better plan and perform operations on unborn babies with severe birth defects.

The project has been funded by the Wellcome Trust and EPSRC under the 'Innovative Engineering for Health' initiative, which also involves paediatric surgeons and doctors at Great Ormond Street Hospital and University College London Hospitals NHS Foundation Trust.

Professor Ourselin said: “Operating on babies in the womb is not undertaken lightly and is reserved for just a handful of the most severe defects. Very few procedures can be done safely in the fetus using keyhole surgery, and more complex ones require opening the uterus, which puts both the mother and unborn baby at risk. Less than 1,000 procedures a year have been attempted at various specialised clinics around the world.

“Our aim is to combine less invasive surgical technologies with stem cell and gene therapies to treat a wide range of diseases in the womb, with considerably less risk to both mother and baby."

In addition to working on surgical imaging techniques, the team will develop new instruments to improve the flexibility and precision of the surgeon, as well as adaptations to deliver stem cell therapies to the unborn baby in the womb. A training platform will also be developed that will enable surgeons to gain the necessary skills before operating on pregnant mothers.

Around one in 100 babies are born with a severe birth defect, and collectively these are estimated to be responsible for over a third of all paediatric hospital admissions and up to a half of the total cost of paediatric hospital treatment.

Birth defects are usually detected prenatally by screening with ultrasound and some of these can benefit from surgical correction because therapy cannot wait until after birth. Performing surgery whilst the fetus is still in the womb improves survival chances and significantly reduces life-time disability.

Pioneered in the 1980s, surgery on unborn babies has been shown to be effective to treat conditions arising before birth like spina bifida, where a lesion on the back leaves the spinal cord exposed in the womb, and twin-twin transfusion syndrome, where blood passes unequally between twins who share a placenta.

Dr Ted Bianco, Director of Technology Transfer at the Wellcome Trust, said: “Developing the tools surgeons need to improve foetal surgery will be transformative both in treating severe birth defects and in developing the next generation of surgical technology. Whilst it may be many years before the full potential of the research will be realised, the size and duration of the awards from the Trust and EPSRC are designed to enable our award holders to be bold in their approach.”

Professor Philip Nelson, Chief Executive of EPSRC, said: “This research shows how engineering and scientific developments can save and improve lives. We are very proud to be working in partnership with the Wellcome Trust to support this research. Hopefully it will improve the survival chances of unborn children by making fetal surgery safer and treatment better focussed.”


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