title: Computer-assisted surgical planning and intraoperative guidance in fetal surgery: a systematic review.
abstract: Fetal surgery has become a clinical reality, with interventions for twin-to-twin transfusion syndrome (TTTS) and spina bifida demonstrated to improve outcome. Fetal imaging is evolving, with the use of 3D ultrasound and fetal MRI becoming more common in clinical practise. Medical imaging analysis is also changing, with technology being developed to assist surgeons by creating 3D virtual models that improve understanding of complex anatomy, and prove powerful tools in surgical planning and intraoperative guidance. We introduce the concept of computer-assisted surgical planning, and present the results of a systematic review of image reconstruction for fetal surgical planning that identified six articles using such technology. Indications from other specialities suggest a benefit of surgical planning and guidance to improve outcomes. There is therefore an urgent need to develop fetal-specific technology in order to improve fetal surgical outcome.
authors.affiliation: Translational Imaging Group, CMIC, University College London, London, UK.|Institute for Women's Health, University College London, London, UK.
authors.forename: Rosalind
authors.initials: R
authors.lastname: Pratt
authors.affiliation: Department of Obstetrics, University Hospitals KU Leuven, Leuven, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: Deprest
authors.affiliation: Translational Imaging Group, CMIC, University College London, London, UK.
authors.forename: Tom
authors.initials: T
authors.lastname: Vercauteren
authors.affiliation: Translational Imaging Group, CMIC, University College London, London, UK.
authors.forename: Sebastien
authors.initials: S
authors.lastname: Ourselin
authors.affiliation: Institute for Women's Health, University College London, London, UK.
authors.forename: Anna L
authors.initials: AL
authors.lastname: David
mesh_terms: D005260:Female; D046128:Fetal Therapies; D006801:Humans; D021621:Imaging, Three-Dimensional; D010347:Patient Care Planning; D011247:Pregnancy; D025321:Surgery, Computer-Assisted