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Surgery in the womb to be improved by research into new tools and imaging techniques

2 June 2014

fetal surgery small
Surgeons will be able to use better tools, imaging techniques and therapies in future operations on unborn babies due to a £10 million award from the Wellcome Trust and the Engineering and Physical Sciences Research Council (EPSRC) to develop these technologies.

Pioneered in the 1980s, surgery on unborn babies has been shown to be effective for treating 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.

Now, research led by engineers at UCL (University College London) and KU Leuven in Belgium will develop novel imaging techniques that can be used before and during surgery to visualise blood circulation, enabling 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.

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 a hundred 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 in some cases therapy cannot wait until after birth. Performing surgery while the fetus is still in the womb can improve survival chances and significantly reduce lifetime disability.

Professor Sebastien Ourselin from the UCL Centre for Medical Image Computing, who is leading the research, 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."

Dr Ted Bianco, Director of Technology Transfer at the Wellcome Trust, said: "Developing the tools surgeons need to improve fetal 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 focused."

Mr Paolo de Coppi, consultant paediatric surgeon at Great Ormond Street Hospital, who is leading on GOSH’s involvement in the project, said: “As the safety of fetal surgery increases, it is possible that many of the operations that we currently perform on newborn babies at Great Ormond Street will become fetal procedures. That’s very good news for a child’s long-term outlook, because the earlier we can correct a serious defect in a growing fetus, the better the outcome is likely to be for the child and their future development.”
 

Contact:

Clare Ryan
Senior Media Officer
Wellcome Trust
T +44 (0)20 7611 7262
M +44 (0)7534 143849
c.ryan@wellcome.ac.uk
 
Notes for editors
 
About the Wellcome Trust
The Wellcome Trust is a global charitable foundation dedicated to achieving extraordinary improvements in human and animal health. It supports the brightest minds in biomedical research and the medical humanities. The Trust’s breadth of support includes public engagement, education and the application of research to improve health. It is independent of both political and commercial interests.
 
About the Engineering and Physical Sciences Research Council
The Engineering and Physical Sciences Research Council (EPSRC) is the UK's main agency for funding research in engineering and the physical sciences. EPSRC invests around £800 million a year in research and postgraduate training, to help the nation handle the next generation of technological change. The areas covered range from information technology to structural engineering, and mathematics to materials science. This research forms the basis for future economic development in the UK and improvements for everyone's health, lifestyle and culture. EPSRC works alongside other Research Councils with responsibility for other areas of research. The Research Councils work collectively on issues of common concern via Research Councils UK.
 
About UCL (University College London)
Founded in 1826, UCL was the first English university established after Oxford and Cambridge, the first to admit students regardless of race, class, religion or gender, and the first to provide systematic teaching of law, architecture and medicine. We are among the world's top universities, as reflected by performance in a range of international rankings and tables. UCL currently has almost 29,000 students from 150 countries and in the region of 10,000 employees. Our annual income is more than £900 million.
 
About Great Ormond Street Hospital
Great Ormond Street Hospital for Children NHS Foundation Trust is the country’s leading centre for treating sick children, with the widest range of specialists under one roof. With the UCL Institute of Child Health, we are the largest centre for paediatric research outside the US and play a key role in training children’s health specialists for the future. Our charity needs to raise £50 million every year to help rebuild and refurbish Great Ormond Street Hospital, buy vital equipment and fund pioneering research. With your help we provide world class care to our very ill children and their families.
Wellcome Trust, Gibbs Building, 215 Euston Road, London NW1 2BE, UK T:+44 (0)20 7611 8888