Operative fetoscopy via telesurgery

Abstract

We describe a case in which telesurgical consultation from Tampa, Florida, USA was used to accomplish operative fetoscopy in Santiago, Chile for the treatment of a twin pregnancy involving an acardiac twin. The procedure was successful and a healthy infant was delivered at 37.5 weeks. Operative fetoscopy, a surgical approach to correct birth defects in utero via combined ultrasound and endoscopy, is only available in a handful of centers worldwide. Telesurgery makes use of telecommunication to allow a surgeon at a primary operating site to consult with another experienced surgeon for complex surgical cases. This case illustrates the potential for ultrasound and telesurgery to expand the horizons of operative fetoscopy.

Optimal Method and Timing of Intrauterine Intervention in Twin Reversed Arterial Perfusion Sequence: Case Study and Meta-Analysis

“…Early attempts were highly invasive and involved hysterotomy and removal of the acardiac twin [2,3,4]. Subsequently, a series of other less invasive intrauterine interventions aiming to arrest the circulation of the acardiac twin were introduced [5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75]. These included insertion of cord coils, ligation with or without transection of the umbilical cord, endoscopic laser coagulation of placental anastomoses between the pump and acardiac twins, endoscopic laser coagulation and endoscopic or ultrasound-guided monopolar or bipolar diathermy of vessels within the cord supplying the acardiac twin and, more recently, ultrasound-guided ablation of intrafetal vessels by injection of alcohol, monopolar diathermy, laser or radiofrequency.…”

Uso de las tecnologías de información y comunicación para el cuidado del binômio materno-fetal: revisión de tema

“…El cirujano remoto se guió en la gestión exitosa de un embarazo que implica un gemelo acárdico con ultrasonido transmitido, endoscopia e imágenes panorámicas de la sala de operaciones en tiempo real 37 . En otro proyecto entre Australia y Estados…”

Telepresent Intubation Supervision Is as Effective as In-Person Supervision of Procedurally Naive Operators

“…1 Telemedicine is a viable alternative for providing expert consultation and procedural guidance in rural and remote prehospital settings, [2][3][4][5][6] particularly in the fields of trauma and emergency medicine. 7,8 In 2010, Sakles et al 9 reported the first case of a remotely assisted tracheal intubation.…”