{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T13:05:26Z","timestamp":1777381526263,"version":"3.51.4"},"reference-count":22,"publisher":"S. Karger AG","issue":"5","license":[{"start":{"date-parts":[[2024,6,18]],"date-time":"2024-06-18T00:00:00Z","timestamp":1718668800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2024,6,18]],"date-time":"2024-06-18T00:00:00Z","timestamp":1718668800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Fetal Diagn Ther"],"abstract":"<jats:p>Introduction: Maternal laparotomy-assisted fetoscopic surgery for in-utero myelomeningocele repair has shown that a trans-amniotic membrane suture during fetoscopic port placement can reduce postsurgical complications. Fetoscopic laser photocoagulation (FLP) for complex twins is typically performed percutaneously without a transmembrane stitch. However, in scenarios without a placental-free window, maternal laparotomy may be used for recipient sac access. Here, we present the outcomes of our series of laparotomy-assisted FLP cases, including a trans-amniotic membrane suturing of the fetoscopic port. Methods: Retrospective series of twin-twin transfusion syndrome or twin anemia-polycythemia sequence (TAPS) cases treated at 2 fetal centers that underwent maternal laparotomy to FLP from September 2017 to January 2023. We recorded preoperative and operative characteristics, as well as pregnancy and neonatal outcomes. Results: During the study period, 9 maternal laparotomy to FLP cases were performed. Two were excluded for prior percutaneous FLP in the pregnancy. The remaining seven utilized a maternal laparotomy to trans-amniotic membrane stitch with confirmation of proper suture placement under ultrasound guidance, and all surgeries were performed with a single 10 F Check-Flo\u00ae cannula. Mean gestational age (GA) at surgery was 19.1 weeks (range 16 weeks 4 days\u201323 weeks 3 days), with delivery occurring at a mean GA of 35.0 weeks (range 32 weeks 0 days\u201337 weeks 1 day), resulting in a mean latency of 15.8 weeks, significantly longer than what is reported in the literature and our own data (mean latency for percutaneous FLP 10.2, 95% CI 9.9\u201310.5). Furthermore, all cases underwent iatrogenic delivery before labor onset, with the lone delivery prior to 34 weeks due to concern for post-laser TAPS. Conclusion: This case series of laparotomy to FLP with trans-amniotic stitch, demonstrated no cases of spontaneous preterm birth and a longer-than-expected latency from surgery to delivery. Larger studies are warranted to investigate this approach. <\/jats:p>","DOI":"10.1159\/000539894","type":"journal-article","created":{"date-parts":[[2024,6,18]],"date-time":"2024-06-18T21:00:34Z","timestamp":1718744434000},"page":"510-515","source":"Crossref","is-referenced-by-count":7,"title":["Should We Stitch-Close the Fetoscopic Percutaneous Access? A Case-Series of Laparotomy to Trans-Amniotic Membrane Suturing for Intrauterine Port Placement in Fetoscopic Surgery for Twins"],"prefix":"10.1159","volume":"51","author":[{"given":"Braxton","family":"Forde","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerrado","family":"Sepulveda Gonzalez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4362-8431","authenticated-orcid":false,"given":"Foong-Yen","family":"Lim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tayde","family":"Arroyo-Lemarroy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eduardo Noe","family":"Nava Geurrero","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esteban","family":"Lizarraga-Cepeda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mounira","family":"Habli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"McKinney","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mallory","family":"Hoffman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose L.","family":"Peiro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2024,6,18]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.03.050"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.10.880"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2020.07.041"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.07.046"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1515\/jpm.2010.061"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13206"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004970"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15972"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1002\/pd.6415"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15958"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1002\/uog.18904"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1159\/000479505"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1159\/000304512"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1002\/jum.14831"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15821"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2016.1214123"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7476"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12547"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1002\/uog.23708"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1159\/000528473"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1159\/000519910"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1159\/000525768"}],"container-title":["Fetal Diagnosis and Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/fdt\/article-pdf\/51\/5\/510\/4283367\/000539894.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/fdt\/article-pdf\/51\/5\/510\/4283367\/000539894.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T15:26:40Z","timestamp":1745422000000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000539894"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,18]]},"references-count":22,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,10,1]]},"published-print":{"date-parts":[[2024,10,2]]}},"URL":"https:\/\/doi.org\/10.1159\/000539894","archive":["Portico"],"relation":{},"ISSN":["1015-3837","1421-9964"],"issn-type":[{"value":"1015-3837","type":"print"},{"value":"1421-9964","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,18]]}}}