Actively Recruiting

Phase Not Applicable
Age: 18Years - 45Years
FEMALE
ID06056635

A Prospective Study on the Role of Karl Storz Curved and Straight Fetoscopes for Fetoscopic Intrauterine Procedures

Led by Boston Children's Hospital · Updated on 2024-09-25

50

Participants Needed

1

Research Sites

21 weeks

Total Duration

On this page

AI-Summary

What this Trial Is About

Researchers are studying the use of two new surgical devices, the Karl Storz Curved and Straight Fetoscopes, to assist in minimally invasive in-utero surgeries. These devices help surgeons see inside the uterus during procedures to treat fetal conditions like twin-twin transfusion syndrome and other complex anomalies. The study aims to assess surgical outcomes, complications, and gestational age in patients treated with these scopes, helping to understand their potential benefits in fetal surgery. The curved fetoscope is designed for patients with an anterior placenta, while the straight fetoscope is used for those with a posterior placenta. Both scopes assist in fetoscopic laser photocoagulation, a procedure that seals abnormal blood vessels in the placenta using laser energy. This research is a non-randomized, single arm study where eligible patients undergo intrauterine procedures with either the curved or straight scopes based on placenta position. The study will collect data on the success of the procedures and related complications for descriptive analysis. Participants will be monitored through the procedure and follow-up until birth and shortly after. The study will evaluate outcomes such as the rate of completed fetoscopic procedures, fetal survival at birth, and various maternal and fetal complications. Researchers will also track gestational age at delivery, procedure length, and short-term neonatal health. The total study duration extends over several years to capture both immediate and longer-term results of using these devices in fetal surgery.

CONDITIONS

Brief Title

A Prospective Study on the Role of Karl Storz Curved and Straight Fetoscopes (11508AAK and 11506AAK) for Fetoscopic Intrauterine Procedures

Who Can Participate

Age: 18Years - 45Years
FEMALE

Eligibility Criteria

Eligible

You may qualify if you...

  • Pregnant patient with a condition requiring in-utero surgery
  • Patient must be eligible for anesthesia
  • Patient and father of the fetus (if available) are able to provide signed informed consent
Not Eligible

You will not qualify if you...

  • Allergy or previous adverse reaction to any ancillary medication specified in this protocol that has no alternative
  • Preterm labor, preeclampsia, or uterine anomaly such as a large fibroid tumor in the current pregnancy
  • Suspicion of a major recognized congenital syndrome on ultrasound or MRI incompatible with postnatal life
  • Pre-pregnancy maternal BMI greater than 40
  • High risk for fetal hemophilia
  • Fetal aneuploidy or variants of known significance if amniocentesis was performed
  • Contraindication to abdominal surgery or fetoscopic surgery

AI-Screening

AI-Powered Screening

Complete this quick 3-step screening to check your eligibility

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Your Study Journey

Screening

Duration - 2 to 4 weeks

Participants are screened for eligibility to participate in the trial.

1 visit (in-person)

Implementation

Duration - Procedure day plus immediate recovery

Participants undergo in-utero surgery using either a Karl Storz Curved or Straight Fetoscope to assist with visualization during the procedure.

1 surgical procedure visit (in-person)

Post-operative Follow-up

Duration - Up to birth and 30 days post-birth

Participants are monitored for short and long-term outcomes including fetal survival, complications, and gestational age at delivery.

Multiple follow-up visits until delivery and neonatal period

Trial Site Locations

Total: 1 location

1

Boston Children's Hospital

Boston, Massachusetts, United States, 02115

Actively Recruiting

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Research Team

B

Brittany Gudanowski

How is the study designed?

Study Type

INTERVENTIONAL

Masking

NONE

Allocation

NA

Model

SINGLE_GROUP

Primary Purpose

TREATMENT

Number of Arms

1

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Published Research Related To This Trial

The Impact of Entry Technique and Access Diameter on Prelabour Rupture of Membranes Following Primary Fetoscopic Laser Treatment for Twin-Twin Transfusion Syndrome.

Scott G Petersen, Kristen S Gibbons, Francois I Luks...

https://pubmed.ncbi.nlm.nih.gov/27073886

Fetoscopic laser coagulation in 1020 pregnancies with twin-twin transfusion syndrome demonstrates improvement in double-twin survival rate.

W Diehl, A Diemert, D Grasso...

https://pubmed.ncbi.nlm.nih.gov/28477345

Alternative technique for Nd: YAG laser coagulation in twin-to-twin transfusion syndrome with anterior placenta.

J A Deprest, D Van Schoubroeck, P P Van Ballaer...

https://pubmed.ncbi.nlm.nih.gov/9644775

Comparison between laparoscopically assisted and standard fetoscopic laser ablation in patients with anterior and posterior placentation in twin-twin transfusion syndrome: a single center study.

Alireza A Shamshirsaz, Pouya Javadian, Rodrigo Ruano...

https://pubmed.ncbi.nlm.nih.gov/25559783

Outcomes of laparoscopy-assisted fetoscopic laser photocoagulation for twin-twin transfusion syndrome: An established alternative for inaccessible anterior placenta.

Eyal Krispin, Ahmed A Nassr, Jimmy Espinoza...

https://pubmed.ncbi.nlm.nih.gov/34658043

Novel Application of Laparoscopic Ultrasound for Fetoscopic Laser Ablation in Twin-Twin Transfusion Syndrome with Complete Anterior Placenta.

Marcus D Jarboe, Deborah R Berman, Tiffany Wright...

https://pubmed.ncbi.nlm.nih.gov/26555815

Trocar-assisted selective laser photocoagulation of communicating vessels: a technique for the laser treatment of patients with twin-twin transfusion syndrome with inaccessible anterior placentas.

Ruben A Quintero, Ramen H Chmait, Patricia Wiseman Bornick...

https://pubmed.ncbi.nlm.nih.gov/19941443