Robotic Fetal Surgery: The Next Frontier?

The modern era of surgery has been characterized by the growing permeation of robotic surgery. Smaller incisions, enhanced dexterity in confined spaces, and magnification make robotic surgery ideally suited for the growing field of prenatal intervention, wherein fetal conditions are surgically addressed within the confines of the womb. In this chapter, we review the history of fetal surgery and the features that make it both challenging and unique, particularly the multidisciplinary nature of maternal-fetal intervention and the risk of precipitating premature labor. We discuss the growing bodies of evidence for fetal myelomeningocele closure, interventions for lower urinary tract obstruction, and various other conditions well-suited for robotic application. As robotic technology rapidly improves with newer platforms, smaller instruments, enhanced simulation, and telesurgery capabilities, the frontier of robotic fetal surgery will be propelled into the next era.