Technical aspects of laser surgery for TTTS

Author(s):
Akkermans, J.
Published
2017
Publication type
Doctoral Thesis

Abstract

This thesis consists of a series of studies on technical and procedural aspects of laser surgery for the treatment of twin-twin transfusion syndrome (TTTS), a causal treatment modality first described by De Lia et al. in 1990. TTTS is caused by unbalanced blood flow across placental vascular communications between both twins called anastomoses.

The aim of the treatment is to close of all anastomoses in order to separate both fetal circulations. In part one, we give a general introduction to the subject and its challenges.

Part two consists of studies evaluating current practice with the aim to identify potential areas of improvement. Part three deals with several techniques, the impact of laser energy and placental damage and, it introduces a model to investigate different technical parameters of the laser procedure. Finally, in part four, we discuss the development of a standardized training model for fetoscopic laser surgery.

Twin-twin transfusion syndromeLaser surgeryMonochorionic twin pregnancies
Defense date
2017-06-22
Language
English
Supervisor(s)
Oepkes, D.; Lopriore, E.
Advisor(s)
Dobbelsteen, J. van den
Committee member(s)
Jansen, F.W.; devlieger, R.; Go, A.T.J.I.
Qualification
Ph.D.
Degree granting institution
Medicine, Leiden University, Leiden
hdl
1887/49723
ISBN(s)
9789082692006

Funding

Sponsorship
LUMC departments of obstetrics and neonatology; NWO