Laser photocoagulation is an in-utero surgical treatment for Twin-to-Twin Transfusion Syndrome (TTTS). It uses laser energy to close the blood vessels on the surface of the placenta so that the babies’ blood is no longer shared.
The procedure involves placing a very thin camera called a fetoscope into the uterus through a tiny 2-3mm incision in the skin. The surgery is done in an operating room using spinal anesthesia, and typically takes 30-to-60 minutes.
The fetoscope allows the surgeon to identify the small connecting blood vessels on the surface of the placenta. They close close the blood vessels using laser energy from a small laser fiber through a channel on the fetoscope. There may be as few as one or two connections, or they may be as many as 19 or 20 depending on the specific case.
EvergreenHealth's Dr. Martin Walker and Dr. Bettina Paek are among the few physicians in the country trained in laser photocoagulation.
They have performed more than 350 procedures at EvergreenHealth, with the following results:
Possible risks include: chorioamnionitis, rupture of membranes, premature labor and miscarriage. Maternal complications, such as abruption and infection, occur in less than 1% of cases. Premature labor occurs in up to 10% of cases.
Pregnancies are considered appropriate for laser photocoagulation in Twin to Twin Transfusion Syndrome when they have the following:
Patients with the following situations may not be suitable for laser photocoagulation in TTTS:
After the surgery, you can return to the care of your referring provider for the remainder of your pregnancy and delivery.
Both you and your provider can always contact us if there are any questions or concerns.
If you are interested in a referral for laser photocoagulation, either you or your provider can contact our program coordinator:
Melissa Dorn, RN, MN
Fetal Therapy Coordinator
1.866.FETSURG (toll free)