Feb. 14, 1997 CHICAGO, Ill. (2/13/1997) -- A condition once considered hopeless for 6,000 identical twin babies each year in the United States is now being treated with a new, pioneering laser surgical procedure developed by Dr. Julian E. De Lia, associate professor of obstetrics and gynecology at the University of Illinois at Chicago Medical Center.
The condition, twin-to-twin transfusion syndrome, occurs when identical twins share a single placenta, with blood vessel connections allowing passage of blood from one twin into the other. In severe cases, the "donor" twin becomes very anemic and the "recipient" twin becomes overloaded with fluid and develops heart failure. Without treatment, the most likely outcome is death of one or both twins. Or, if the twins survive, birth defects or cerebral palsy can result.
De Lia is one of only a handful of surgeons around the world who perform this procedure, with patients coming to him from 20 states and Canada. He saw his first case of twin-to-twin transfusion syndrome in 1983 at the University of Utah Medical Center. Over the next several years, he did research and developed an in-utero laser surgical technique that he began using in 1988.
In the procedure, the mother is given anesthesia and a thin, telescope-like device called a fetoscope is inserted into the abdomen through a small incision. The placental vessels connecting the twins can be seen through the fetoscope. De Lia then fires a surgical laser at the vessels through the fetoscope to seal or cauterize the connecting vessels. The procedure takes only 30 to 45 minutes.
De Lia has performed about 70 of the operations, including seven since he came to the UIC Medical Center last September. In about 75 to 80 percent of the cases at least one twin survived, and in 65 to 70 percent both twins survived, with neurological damage occurring in less than 5 percent of the babies and with no ill effects on the mothers.
"Twins are a special blessing to most people, and it's a double tragedy if they end up losing both children," says De Lia. "So for me, it's very gratifying to save these lives.
"I've come up with something that, a few years ago, did not exist in medicine. Now that we're have perfected this procedure, I face the challenges of teaching others how to perform the surgery and disseminating information to parents and the medical community about its availability."
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