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

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!