First in Indonesia: Doctors Successfully Perform Open Fetal Surgery
Indonesia has marked a new milestone in the field of medicine following the successful performance of the country’s first open fetal surgery. The operation was performed on a foetus with myelomeningocele, one of the most severe forms of spina bifida, a congenital spinal defect.
The procedure was carried out by a multidisciplinary team from RSAB Harapan Kita in collaboration with the team from Mater Mothers’ Hospital, Brisbane, Australia, on Tuesday (25/08/2026). Deputy Minister of Health Dante Saksono Harbuwono stated that this success is a significant milestone in the development of Indonesian healthcare services, particularly in managing congenital abnormalities while the baby is still in the womb.
“This is the first open fetal surgery in Indonesia, meaning surgery on the foetus while still in the womb. This is an extraordinary breakthrough, and it was all performed by Indonesian doctors,” said Dante, as quoted from a Ministry of Health statement on Wednesday (02/09/2026).
Myelomeningocele is a congenital defect of the spine and nervous system that occurs when the spinal column and neural tissues do not close completely during fetal development. This condition can lead to various serious issues, ranging from neurological impairment, paralysis, and bladder and bowel dysfunction, to an increased risk of hydrocephalus.
Such abnormalities can be identified during pregnancy through fetomaternal ultrasonography (USG). Once a diagnosis is established, patients must undergo a series of examinations and screenings, including genetic testing, before fetal surgery is considered.
The Head of the Obstetrics and Gynaecology Team at RSAB Harapan Kita, Gatot Abdurrazak, stated that the patient in this inaugural operation was referred with spina bifida when the gestational age reached 18 weeks.
“This provided the opportunity to perform the repair because the window is only available until 26 weeks. We moved quickly and received full support from the management and the entire team,” said Gatdo.
Open fetal surgery is a complex procedure because the operation is performed while the foetus is still in the womb. The mother first receives anaesthesia. Doctors then perform a controlled opening of the uterus to access the foetus and repair the myelomeningocele defect.
Once the repair is complete, the foetus is placed back into the uterus. The uterus is then closed and returned to the mother’s body so that the pregnancy can continue.
The Head of the Neurosurgery Team at RSAB Harapan Kita, Alfi Aulia Rahmah, explained that myelomeningocele is the most severe form of spina bifida. Repairing it while the baby is still in the womb is expected to reduce further nerve damage and suppress the risk of long-term complications, including hydrocephalus.
“This is not just a neurosurgical task. Everyone plays a vital role. In intrauterine procedures, the crucial element is maintaining foetal stability. If the foetus becomes unstable, the surgery must be halted,” said Alfi.
The operation involved many medical disciplines, including neurosurgeons, fetomaternal specialists, obstetricians, gynaecologists, anaesthetists, nurses, and other support staff. The team from Mater Mothers’ Hospital, Australia, assisted in the surgery. Maternal Fetal Medicine specialist Glenn Radford noted that the first operation proceeded well without complications.
“Yesterday, in a historic event in Indonesia, we worked alongside our colleagues from Harapan Kita to perform the first surgery, and the results were very good. No complications occurred,” said Radford.
Capabilities for fetal therapy have actually been developed at RSAB Harapan Kita for over two decades. The hospital has been performing intrauterine transfusions since 2005 and has developed fetoscopic procedures since 2011.
A number of fetal treatments have also been developed, including vesicoamniotic shunting, thoracoamniotic shunting, and fetoscopic laser for treating twin-to-twin transfusion syndrome (TTTS). RSAB Harapan Kita has handled approximately 200 fetoscopic laser cases.
The President Director of RSAB Harapan Kita, Reni Wigati, stated that the hospital’s multidisciplinary team is now prepared. Following the conclusion of the Australian team’s mentorship, RSAB aims to continue providing open fetal surgery services independently.
“Following this, RSAB will proceed with subsequent patients and also transfer this capability to other hospitals that specialise in fetomaternal care,” she said.
This capability will later be expanded through a mentorship programme so that similar services can be available in other hospitals. Dante noted that the success of this first operation demonstrates that the capabilities of Indonesia’s medical personnel and medical technology are advancing, meaning many procedures previously performed abroad can now be conducted domestically.
“The technology is extraordinary, and the skills of our doctors in Indonesia are now capable. This serves as a gift for the 17th of August [Indonesian Independence Day] for Indonesian medicine, as we can now perform open fetal surgery on the first Indonesian baby,” said Dante.