ArticleBJOG : an international journal of obstetrics and gynaecology2025
Fetoscopic Robotic Open Spina Bifida Treatment (FROST): A Preclinical Feasibility and Learning Curve Study.
Article in BJOG : an international journal of obstetrics and gynaecology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed.
- A Needle Lasso Method for Port Site Closure and Amniotic Membrane Plication in Fetoscopic Surgery.BJOG : an international journal of obstetrics and gynaecology · 2026Article
- Cumulative Summation Test for Learning Curve in Vaginal Tightening.International urogynecology journal · 2026Article
- Robotic-assisted fetal myelomeningocele repair: feasibility and technique refinement using a surgical simulation model.Surgical endoscopy · 2026Article
- Advances in Fetal Surgery: A Narrative Review of Therapeutic Interventions and Future Directions.Medicina (Kaunas, Lithuania) · 2025Review
- Assessment of Learning Curve for Radiofrequency Ablation in Twin Reversed Arterial Perfusion Sequence: A Simulation Model Study.Prenatal diagnosis · 2025Article
- Advances in the prevention and prenatal treatment of spina bifida.Discoveries (Craiova, Romania)Review
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
objectiveThe primary aim was to assess the feasibility of robotic OSB repair in a simulation training model, documenting the learning curve and ensuring quality control among surgeons.
designThe learning curve was assessed using the cumulative summation test (LC-CUSUM). Following LC-CUSUM, six additional experiments were performed for competency-cumulative summation (C-CUSUM) analysis to ensure ongoing quality control.
settingThe simulator was created through 3D printing and hand sculpting, simulating a partially exteriorised uterus for laparotomy-assisted laparoscopic OSB surgery. It included a silicone uterus, placenta and foetal manikin with a simulated OSB lesion, replicating the lesion sac, paraspinal muscles and neural placode. POPULATION: Four surgeons participated: an expert Maternal Fetal Medicine consultant, a neurosurgical consultant, a Maternal Fetal Medicine fellow and a neurosurgical resident.
methodsThe surgical procedure included eight steps: uterine access, working space creation, lesion exposition, junctional zone dissection, skin mobilisation, dural patch application, closure of myofascial flaps and closure of skin. Success was defined by precise restoration (suture interval < 3 mm), foetal repair time ≤ 120 min and a GEARS score > 21/30. MAIN OUTCOMES: Learning curve and competency were documented via LC-CUSUM and C-CUSUM.
resultsCompetence was achieved after 15-21 procedures, with novices reaching competency within this range. Participants maintained high performance in subsequent quality-controlled procedures.
conclusionRobotic-assisted foetal OSB surgery in a high-fidelity simulation is feasible, showing promising outcomes for a large animal model and clinical translation.
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