Teaching and quality control in fetoscopic surgery
Fetoscopic surgery is a surgical technique that is used to treat fetus(es) that are still inside the pregnant uterus. Coming years, more fetoscopic surgery will be performed. The most commonly performed procedure is laser surgery for twin-twin transfusion syndrome.
Fetal Care Academy
We show how to monitor performance and address specific subgroups in which laser surgery can be more complicated. Since teaching and training in fetoscopic surgery is challenging, we created and validated an evidence-based evaluation tool for the laser procedure. Lastly, we developed a standardized training curriculum with a high fidelity simulator model.
We use highly realistic silicone simulators that mimic pregnant body. The silicone topping on the model mimics the abdominal wall. Inside there is a mimic of a uterus, which contains water and the placenta.
The individual layers of the abdominal wall, the uterus and placenta have sonographic and compliance properties that mimic the clinical situation. The model allows an operator to practice ultrasound examination of a monochorionic pregnancy, required to select the best site for introduction of the instruments.
The addition of two twin fetuses simulates a realistic complex situation of floating fetal extremities and inability to oversee the entire placental surface. All necessary instruments (i.e. fetoscope, introduction set, endoscopy tower etc.) are used from the local Fetal Medicine center so that participants perform their tasks in a setting that was identical to what would be their clinical environment.
Besides the simulator for laser therapy for TTTS we have a simulator for bipolar cord coagulation, amniocentesis, intrauterine transfusion and fetal shunt placement.