Bending Laser Manipulator for Intrauterine Surgery

A bending laser manipulator has been developed for intrauterine surgery; twin-twin transfusion syndrome (TTTS). TTTS is a condition seen in 10-15% of monochorionic diamniotic twins (a single placenta, separate amniotic sacs) and causes blood volume unbalance between both babies through communicating vessels in the placenta. Although the laser coagulation of communicating vessels in the placenta is effective treatment for TTTS, precise maneuvering of the laser´s tip through one small port in both abdominal and uterine walls is very difficult. In this paper, a bending laser manipulator of diameter 2.4 mm has been proposed to perform the surgery with high dexterity. The manipulator has a laser fiber inside of it and bends through 60 degrees in any direction. Simple handheld interface has been chosen for early clinical use. This manipulator enables minimally invasive intrauterine surgery even when the mother has the anterior placenta and the choices of access path are quite limited