Laser Photocoagulation Treatment of TTTS

Laser photocoagulation is the use of laser light to close the connecting blood vessels on the surface of the placenta so that the babies’ blood is no longer shared.

In the treatment of TTTS, the placenta is inspected with a very thin telescope, which is commonly called a “fetoscope.” Using anesthesia, the scope is placed into the uterus through a tiny hole in the skin. The small connecting blood vessels can then be visualized and “coagulated” using laser light from a small fiber optic passed inside of the scope. The surgery is done in an operating room to assure a sterile environment. The type of anesthesia used is a decision between you, the surgeon and the anesthesiologist. Most commonly we recommend an epidural or a local anesthesia. An epidural anesthetic will cause “numbness” from the waist down and is commonly used for cesarean section.

Video and Treatment Description

 

This video depicts an actual procedure that was performed at UC San Diego Health System. Here is what you are seeing:

  • Entering the uterus (womb) via laparoscopic instruments
  • Looking at the reciepient twin
  • Looking at the donor twin (also called “stuck twin"): You will be able to see the membrane enveloping this twin.
  • Mapping the placenta for communicating (shared) vessels: You will see a red light (the guiding light) on the vesssels.
  • Lasering of the communicating vessels: You will see a blue light lasering the vessels.
  • Reviewing the lasered vessels: You will see white patches on the placenta.
  • Exiting the uterus