Robot-geassisteerde intra-uteriene geaugmenteerde fetoscopie

Twin-Twin Transfusion Syndrome (TTTS) is a life-threatening complication of monochorionic twin pregnancies. Fetoscopic Laser Photocoagulation (FLP) is currently the standard and most effective treatment, enabling coagulation of vascular anastomoses along the shared placental equator. Despite its clinical success, FLP remains a highly demanding procedure due to limited visual feedback from low-contrast fetoscopic images, restricted workspace, and the significant cognitive burden associated with interpreting and coordinating multiple intraoperative imaging modalities. This doctoral research aims to address these challenges through the development and validation of a robot- and computer-assisted framework to enhance surgical precision, visualization, and situational awareness during FLP. The thesis focuses on three interrelated research objectives: (1) advancing robotic ultrasound scanning for intraoperative anatomical reconstruction and instrument tracking, (2) improving the coordination and fusion of ultrasound and fetoscopic images, and (3) overcoming the limited intraoperative field of view through vision-based spatial mapping techniques. Collectively, this work establishes key technical foundations for the transition toward semi-autonomous fetal surgical systems. By integrating robotic hardware, multimodal image fusion, and vision-based SLAM methodologies, the proposed framework demonstrates the feasibility of robot-assisted, image-guided FLP. The results highlight the potential of such systems to reduce surgeon cognitive load, improve procedural safety, and broaden access to high-quality fetal therapy.