I-Corps: Translation Potential of a Steerable, General Fetoscope

The broader impact of this I-Corps project is based on the development of a surgical system that simplifies and optimizes various types of fetal surgeries. Fetal surgery, performed on a developing fetus during pregnancy, can be lifesaving or reduce the burden of congenital diseases. This technology may benefit the estimated 168,000 fetuses affected annually by conditions requiring fetal surgery. The absence of fetoscopes designed specifically for advanced fetal procedures means some fetal centers may avoid offering certain surgeries, or surgeons may rely on tools not optimized for fetal use. When centers do not offer comprehensive fetal therapies, families and communities face unnecessary expenses related to travel and support services. Additionally, the off-label use of pediatric instruments for fetal surgery often results in the use of larger diameter tools, and the need for additional uterine punctures, increasing the risk of maternal complications. These complications can undermine the medical and financial benefits of fetal surgery. This new technology has the potential to improve both maternal and fetal health outcomes and reduce unnecessary prenatal costs related to suboptimal instrumentation. This I-Corps project utilizes experiential learning coupled with a first-hand investigation of the industry ecosystem to assess the translation potential of the technology. The solution is based on the development of a surgical system designed to meet the unique demands of advanced fetal procedures, offering high-quality optics, advanced capabilities like dissection and suturing, and access to difficult-to-reach and hard-to-visualize areas. Currently, no commercially available fetoscopes are specifically designed to minimize risk and maximize functionality for these procedures. This system addresses multiple shortcomings of existing devices that are used off-label for advanced fetal surgeries. This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.