This can be performed when a congenital condition (picked up on prenatal scanning) is threatening the airway of a foetus, and it is believed the baby will be unable to be intubated upon delivery, for example: large tumours (teratomas or blastomas) obstructing the airway, or severe bronchopulmonary sequestration where the lungs are not attached to the main airways.
In this procedure a standard C-section is performed by the obstetricians, and the baby is partially delivered but remains attached to the placenta by the umbilical cord. This means the baby continues to receive oxygen via the placental circulation. An ENT surgeon can then secure the baby's airway, i.e. tracheostomy, and the umbilical cord can then be clamped and the delivery proceeds as normal.
This is obviously a major procedure for mother, baby, and clinical team: the risk of bleeding to the mother is high; the risk of not maintaining the placental circulation adequately and causing low oxygen levels in the baby is very high (and the consequences can be catastrophic); and the cost and manpower needed to actually perform one is extremely high. After all, you need two operating theatres, two anaesthetic teams, an obstetrics team, a paediatric ENT team, and who knows how many nursing and allied professionals.
Learning about this got me to thinking about other types of foetal surgery, of which I don't know much. A swift googling upon returning to my hostel threw up a handful of articles, discussing both open and laparoscopic procedures that can be performed in utero. I had heard of laser ablation of vessels in twin-to-twin transfusion syndrome, but had not realised you could actually take a foetus out, correct neural tube defects or congenital heart malformations, and then return the foetus to the womb to continue gestation! (although how much longer the baby will remain in the womb is tricky - the rates of preterm birth and miscarriage are very high)
The big issue surrounding foetal surgery is, as I'm sure you can imagine, the impact on the mother vs. the impact on the foetus. I'm no ethicolegal whizzkid (unlike H!), so my writing on this will be very brief. It is my understanding, and indeed opinion, that the rights of the mother come before the rights of the foetus; i.e. the potential risks to the mother are of more importance than the potential benefits for the foetus. Especially because there are no benefits of the surgery for the mother, apart from the obvious 'having a child' business.
As foetal surgery becomes more prevalent and more high profile I'm sure all sorts of parties will have their say on the appropriateness of mother vs. foetus rights. For now it's just nice to be able to go 'wooooaah that's really cool!'.
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