**2.2.1 Introduction to fetoscopy**

For a recently aborted fetus with diagnosed congenital malformation, continuation of the pregnancy until termination with a Cesarean delivery, change in timing mode, or place of delivery are the only three options available. Fetal surgery may provide a further solution in these cases. Open fetal surgery is state of the art (Harrison, 2003) (Berris and Shoham, 2006) and is already available in over a dozen clinical centers worldwide. Endoscopic fetal surgery, which is commonly referred as Fetoscopy (Sydorak and Albanese, 2003) is however a medical discipline that is still in its early development stages. Fetal surgery has given the possibility to treat some fetal congenital malformation in utero (diaphragmatic hernia, myelomeningocele, lower urinary tract obstruction).

The R&D of a surgical tool for interventions on the fetus during pregnancy requires highly advanced micro/nanotechnologies from the system integration point of view and a close collaboration with medical doctors to develop it according to their real needs. At present fetal surgery lacks purposely developed micro instrumentations because paediatric surgeons are trying to apply standard minimal invasive instruments to fetal surgery applications. These instruments are far too large for interventions like treatment of pulmonary atresia in such early stage and also do not offer capabilities such as tissue classification.
