Interactive Multi-Interventional Tools

Imagine

Imagine if it were possible to treat any patient needing surgery in an early phase of the disease at any location in the body with only one tiny incision, causing limited trauma to healthy tissue, and have the patient go home the same day and back to work the next week...

The Quest

Unfortunately, the limited functionality of current instruments used in minimally invasive procedures severely hampers effective diagnosis and treatment in many body parts. Therefore, iMIT will develop a new generation of devices with highly advanced functionality at the tip for instantaneous diagnosis and targeted treatment, which will combine diagnosis and therapy in one single procedure. 

LASER Project

Within LASER, as part of the iMIT project (see footer), we focus on a special case of deep-seated vascular malformations as seen in identical-twin pregnancies that are complicated by the twin-to-twin transfusion syndrome (TTTS).

Due to erroneous interconnecting blood vessels (anastomoses) in the placenta, one twin receives too little blood while the other receives too much, so both are endangered.

  • LifeTec Group | TU Delft | AMC | LUMC | LASER, iMIT Project
    LifeTec Group | TU Delft | AMC | LUMC | LASER, iMIT Project
    LifeTec Group | TU Delft | AMC | LUMC | LASER, iMIT Project
  • LifeTec Group | TU Delft | AMC | LUMC | LASER, iMIT Project
    LifeTec Group | TU Delft | AMC | LUMC | LASER, iMIT Project
    LifeTec Group | TU Delft | AMC | LUMC | LASER, iMIT Project
  • LifeTec Group | TU Delft | AMC | LUMC | LASER, iMIT Project
    LifeTec Group | TU Delft | AMC | LUMC | LASER, iMIT Project
    LifeTec Group | TU Delft | AMC | LUMC | LASER, iMIT Project
  • LifeTec Group | TU Delft | AMC | LUMC | LASER, iMIT Project
    LifeTec Group | TU Delft | AMC | LUMC | LASER, iMIT Project
    LifeTec Group | TU Delft | AMC | LUMC | LASER, iMIT Project
  • LifeTec Group | TU Delft | AMC | LUMC | LASER, iMIT Project
    LifeTec Group | TU Delft | AMC | LUMC | LASER, iMIT Project
    LifeTec Group | TU Delft | AMC | LUMC | LASER, iMIT Project

The treatment for TTTS is fetoscopic laser coagulation (FLC), which aims at closing off the vascular anastomoses. FLC involves puncture of the fetal membranes to gain access to the surface of the placenta from inside the amniotic sac. Important risk factors are the occurrence of residual anastomoses due to incomplete coagulation, and premature rupture of membranes.

To improve the outcome of these procedures physicians are in need of tools that can monitor the closure of the vessel during the procedure. Moreover, the development of instruments that allow laser coagulation in deep structures would enable approaching the anastomoses from the other side (i.e. through the placenta), thereby preventing puncture of the fetal membranes.

What was done?

In this research project a system was developed for treatment of deep-seated vascular malformations using laser coagulation while reducing damage to healthy tissue to a minimum.

The main goal within LifeTec Group was to design and create a setup in which human placenta material could be subjected to laser treatment in order to characterize and optimize the laser coagulation process.

In the developed set-up, placenta samples could be placed in a saline bath and kept at a steady 37°C temperature. The cannulated placenta veins were connected to the developed circulation system. The laser fiber was kept in place by a system that allowed for easy and very accurate adjustment and was pointed at the vein either perpendicular or at a 45-degree angle. Fresh porcine blood was used to circulate in the placental vein.

In this way accurate laser coagulations could be performed on the placenta material. This resulted in the first study reporting on laser coagulation efficiency of different power settings for obliterating superficial placental vessels.

To date, despite more than 25 years of laser surgery for TTTS, the ideal power setting for coagulation of anastomosis was unknown.

 

authors, partners, acknowledgement

Scientific paper:

"Impact of Laser Power and Firing Angle on Coagulation Efficiency in Laser
Treatment for Twin-Twin Transfusion Syndrome: An ex vivo Placenta Study"

(you can download the scientific paper by filling out your email address in the dark blue bar above)

 

Authors:

Joost Akkermans | Loes van der Donk | Suzanne H.P. Peeters | Sjoerd van Tuijl | Johanna M. Middeldorp | Enrico Lopriore | Dick Oepkes 

 

Partners:

TU Delft - Dr. J.J. (John) van den Dobbelsteen [link]

TU Delft - Dr. ir. Dennis van Gerwen [link]

LUMC - Prof. Dr. D. (Dick) Oepkes [link]

LUMC - J. (Joost) Akkermans MD, PhD [link]

AMC - Prof. Dr. H.J.C.M. Sterenborg [link]

 

Acknowledgment

This research was supported by the Dutch Technology Foundation (STW), which is part of the Netherlands Organization for Scientific Research (NWO) and which is partly funded by the Ministry of Economic Affairs. 

More about the iMit / Laser project: link

 

  • "“LifeTec Group greatly contributed to the development of our ex-vivo human, blood-perfused placenta model. The model is a major step forward in the study of different placental hemodynamic factors and the characteristics of laser surgery for twin-twin transfusion syndrome. The flexibility and can-do mentality of LifeTec Group is unique. It was a great pleasure working with the team!”"

    Joost Akkermans MD. PhD.
    Resident Obstetrics and Gynaecology at Leiden University Medical Center
Head of Research

Linda Kock

R&D Engineer

Loes van der Donk

Senior Research Engineer

Sjoerd van Tuijl

More 'Cases, Products & Services' >>

©2018 LifeTec Group.  Legal  Credits