{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:00:37Z","timestamp":1786118437311,"version":"build-2736575974"},"reference-count":17,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T00:00:00Z","timestamp":1783209600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T00:00:00Z","timestamp":1783209600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the feasibility and operative performance of a flexible fetoscope (FF) compared with a rigid fetoscope (RF) in the simulated management of twin\u2010to\u2010twin transfusion syndrome (TTTS) with anterior placentation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>A randomized, non\u2010blinded crossover trial was conducted during a national training session for fetal surgeons. Twenty participants each performed a simulated Solomonization procedure using both the FF and RF in a high\u2010fidelity TTTS simulator. The FF consisted of a single\u2010use flexible video\u2010endoscope inserted into a 10 Fr, 230\u2010mm stainless steel cannula. Outcomes included the visualization of the recipient cord insertion, the completeness of Solomonization, operative time, tangential vessel approach, and spatial analysis of the Solomonization path to quantify equatorial deviation and its direction relative to the intertwin membrane.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      No statistically significant differences were observed between the FF and RF in recipient cord insertion visualization (80% vs. 40%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.17), complete Solomonization (95% vs. 70%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.58) and total procedure duration (11.30\u00a0\u00b1\u00a03.09 vs. 9.00\u00a0\u00b1\u00a02.36\u00a0min;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.08). The overall vessel approach angle was slightly more perpendicular with the FF (median 3.5[IQR 3.0\u20134.7]) than with the RF (3.0[2.2\u20133.7];\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.08). Spatial analysis revealed a larger equatorial deviation area with the FF (31.1\u00a0\u00b1\u00a010.3 vs. 17.8\u00a0\u00b1\u00a07.1\u00a0cm\n                      <jats:sup>2<\/jats:sup>\n                      ;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.01) and a more anterior trajectory (signed deviation 15.6\u00a0\u00b1\u00a010.2 vs. \u221215.0\u00a0\u00b1\u00a017.0\u00a0cm\n                      <jats:sup>2<\/jats:sup>\n                      ;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Flexible fetoscopy appears feasible in the setting of anterior placentation in simulated TTTS surgery, supporting its potential clinical value and the need for dedicated training before clinical translation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pd.70213","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T04:28:33Z","timestamp":1783312113000},"page":"1472-1479","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Performance of a Flexible Versus Rigid Fetoscope in the Simulated Management of Twin\u2010to\u2010Twin Transfusion Syndrome"],"prefix":"10.1002","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9604-2082","authenticated-orcid":false,"given":"Emmanuel","family":"Rault","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Fetal Medicine Hospices Civils de Lyon Femme M\u00e8re Enfant Hospital  Bron France"},{"name":"Centre de Comp\u00e9tence Maladies Rares pour Les Complications Li\u00e9es au Placenta des Grossesses Monochoriales (PaRaDiGM)  Bron France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerome","family":"Massardier","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Fetal Medicine Hospices Civils de Lyon Femme M\u00e8re Enfant Hospital  Bron France"},{"name":"Centre de Comp\u00e9tence Maladies Rares pour Les Complications Li\u00e9es au Placenta des Grossesses Monochoriales (PaRaDiGM)  Bron France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elsa","family":"Limouzin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Fetal Medicine Hospices Civils de Lyon Femme M\u00e8re Enfant Hospital  Bron France"},{"name":"Centre de Comp\u00e9tence Maladies Rares pour Les Complications Li\u00e9es au Placenta des Grossesses Monochoriales (PaRaDiGM)  Bron France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6372-9235","authenticated-orcid":false,"given":"Mona","family":"Massoud","sequence":"additional","affiliation":[{"name":"Centre de Comp\u00e9tence Maladies Rares pour Les Complications Li\u00e9es au Placenta des Grossesses Monochoriales (PaRaDiGM)  Bron France"},{"name":"Department of Obstetrics and Fetal Medicine Centre Hospitalier Lyon Sud University Hospital Hospices Civils de Lyon  Pierre B\u00e9nite France"},{"name":"Claude Bernard University Lyon 1  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyril","family":"Huissoud","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Fetal Medicine Hospices Civils de Lyon Femme M\u00e8re Enfant Hospital  Bron France"},{"name":"Centre de Comp\u00e9tence Maladies Rares pour Les Complications Li\u00e9es au Placenta des Grossesses Monochoriales (PaRaDiGM)  Bron France"},{"name":"Claude 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France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,5]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.29166"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032597"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.22054"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000547995"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000528815"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogc.2017.10.028"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4284"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15734"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14916"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2021.11.1054"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogoh.2022.102352"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5283"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767050903177177"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.5955"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11548\u2010023\u201002905\u20102"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOU.0000000000001141"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2016.04.004"}],"container-title":["Prenatal 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