Surgery of the cleft palate: repair using the operating microscope with radical muscle retropositioning – the GOStA approach. The aim of cleft palate surgery is to minimise damage which results in impaired maxillary growth, and to maximise outcome in terms of velopharyngeal function. Techniques developed by the author, building on work by many and employed by the North Thames Cleft Lip and Palate Centre at Great Ormond Street Hospital/St Andrew’s Centre (GOStA) appears to offer one way of achieving these aims. However, the learning curve is long.