Practice surgery on a silicone uterus

It’s a funny sight: surgery on a silicone uterus and baby. For doctors at Erasmus MC Sophia, it’s a godsend. Now, they can practice surgery for closing spina bifida during pregnancy, without opening the uterus. ‘You can keep rebuilding the silicone baby.’

A buzz of enthusiasm prevails in the OR of the Erasmus MC Sophia Children’s Hospital. It is the first time that doctors in the Netherlands practice on a silicone uterus. Eventually, they will be able to repair spina bifida during pregnancy without opening the uterus. ‘Better for the child and safer for the mother,’ says pediatric neurosurgeon Jochem Spoor. Medical students, together with an engineer from TU Delft, made the silicone uterus and accompanying baby.

Operating table

Spoor and gynaecologist-perinatologist Philip DeKoninck begin by making two small openings in the uterine wall and inserting portals. Through one goes a camera, which is how they locate the split spine on the silicone baby. The instruments go through the other portal. The membrane of the spina bifida is carefully cut open. After the fluid drains away, the spinal cord slowly sinks back to where it belongs. After this, the area is stitched up watertight. The video below shows the two men in action.

While Spoor and DeKoninck complete the exercise surgery, medical students Fatima Tahib and Lis van Gastel explain how they worked with doctor and PhD student Willem van Weteringen and TU Delft PhD student in biomedical engineering Frank Sterke to create the uterus and accompanying baby: ‘With a 3D printer, we first printed a mold. We then cast the silicone inside that to form the uterus.’

Practice baby

‘You can rebuild the practice baby,’ Tahib informs us. She shows how the open back can be adjusted to different heights. The placenta can also be placed differently in the uterus. In this way, the students can create a variety of exercise situations for the surgeons.

Spoor explains why this is such a clever concept: “With the silicone uterus, we can simulate the actual situation. Before we start operating for the first time, we can already think about the best plan of action. How are we going to position ourselves, for example, and what is the best placement for the baby in the womb?’ In two years, Spoor hopes to conduct the first operations in Rotterdam.

The photo above shows from left to right: Jochem Spoor, Philip DeKoninck, Willem van Weteringen, Fatima Tahib, Frank Sterke en Lis van Gastel.