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What they didn't teach you in laser school - Part 1

What they didn't teach you in laser school - Part 1

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Welcome to "What they didn't teach you in laser school"! This two-parter is going to be filled with Dr. Moise's tips and tricks (and some of Erin's too) as we share the following topics: 

  • Pre-operative evaluation tips
    • Identifying cord insertions via ultrasound
    • Following the lie of the donor twin to find the inter-twin anastomotic plane
      • Not true for “cocoon” sign
    • Re-evaluate and confirm cord insertions and anticipated cannula insertion site in the OR
    • Confirming renal blood flow in the donor twin
      • Renal agenesis
  • Intraoperative tips
    • Anesthesia type
    • Maternal drugs we use & don’t use
    • Operative cannula placement
      • Patients with a higher BMI or thick abdominal wall
        • Using a ‘spike’ AKA ‘harpoon’ for entry
        • Spinal anesthesia for cut-down
      • Anterior placenta
        • Patient positioning
        • Laparoscopic approach
      • Check uterine wall for vessels with color flow Doppler
      • Counterpressure
    • Intraoperative bleeding
      • Amnioexchange / rapid infuser
      • Using humidified CO2 for anterior placenta
      • Pediatric foley
    • Intraoperative septostomy
      • Inadvertent vs. purposeful septostomy
      • Complications
        • Amniotic band syndrome
        • Tangled cords

Tune in next week for part 2!

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