Fetoscopic Laser Photocoagulation

Fetoscopic laser photocoagulation is a surgical treatment for Twin-to-Twin Transfusion Syndrome (TTTS). 

The procedure involves placing a fetoscope into the uterus through a 2-3mm skin incision. Laser energy is then used to seal the anastomotic blood vessels on the surface of the placenta, restoring balance to blood and nutrient flow to the fetuses.

It is done in an operating room under spinal, local or general anesthesia and takes approximately 30-60 minutes. 

After the procedure, the mother returns to the care of her obstetrician for the remainder of her pregnancy and delivery.

Our Results

Evergreen's Dr. Martin Walker and Dr. Bettina Paek are among only a handful of physicians in the world trained in fetoscopic laser photocoagulation. 

They have performed more than 220 procedures at Evergreen, with the following results:

• One twin survives in 90% of the cases
• Both twins survive in 60-70% of the cases
• Less than 5% of surviving twins have brain damage

This compares favorably in randomized trials with amnioreduction and septostomy, where fetal survival is significantly lower and the fetal brain damage rate is higher.

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.