4.3 Article

Flexible fetoscope in the treatment of twin-to-twin transfusion syndrome

Journal

ANZ JOURNAL OF SURGERY
Volume 91, Issue 11, Pages 2499-2502

Publisher

WILEY
DOI: 10.1111/ans.17225

Keywords

fetal surgery; fetoscopy; twin-twin transfusion syndrome

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Funding

  1. Shanghai Science and Technology Committee [19441914000] Funding Source: Medline

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The flexible fetoscope made of polyurethane, fiberglass, and stainless steel coils was able to bend encountering obstacles to reduce the possibility of injury to the fetus and placenta. Three pregnant women with anterior placenta and TTTS were treated successfully with this instrument, resulting in live twin births at term. Angiography confirmed that the vascular connections on the surface had been coagulated.
Background Twin-to-twin transfusion syndrome (TTTS) could be treated with fetoscopic laser photocoagulation. For patients with placenta located on the anterior wall of uterus, surgical procedures are difficult. To solve this problem, a flexible fetoscope was designed in our department. Methods The flexible fetoscope was made up of polyurethane, fiberglass and stainless steel coils. The specular body was soft and could bend encountering obstacles, which reduced the possibility of injury to the fetus and placenta. The distal tip of the body could curve from -180 degrees to +270 degrees with the control of the handweel. Three pregnant women of TTTS with anterior placenta was operated with this instrument. Result All pregnant women were treated smoothly and gave live twins birth at term. Through angiography, it was demonstrated that the vascular connections on the surface had been coagulated. Conclusion The flexible fetoscope was a novel instrument in treating TTTS, especially for the anterior placenta.

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