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Not yet recruitingNCT06084247Updated Aug 14, 2025

The Efficacy of the KARL STORZ Curved Fetoscope and Straight Fetoscope for Laser Photocoagulation of Placental Anastomoses

An interventional study of Curved KARL STORZ fetoscope and Conventional Scopes in Twin to Twin Transfusion Syndrome, sponsored by Jimmy Espinoza. Not yet recruiting at 1 site in United States. Open to female participants aged 18 Years to 45 Years. Per ClinicalTrials.gov, last updated 2025-08-14.

Sponsored by Jimmy Espinoza · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
160
Allocation
Randomized
Ages
18 Years to 45 Years
Sex
Female
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Study summary

The purpose of this study is to evaluate the efficacy of KARL STORZ curved fetoscope (11508AAK) and its straight version (11506AAK) for laser photocoagulation of placental anastomoses in patients with an anterior placenta and Twin to Twin Transfusion Syndrome (TTTS).

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Conditions studied

  • Twin to Twin Transfusion Syndrome

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Who can participate

Ages eligible
18 Years to 45 Years
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

  • pregnancy
  • The patient fulfills the criteria for laser photocoagulation of placental anastomoses based on the standard of care
  • fetal diagnosis of twin-to-twin transfusion syndrome
  • Anterior placenta
  • The patient provides signed informed consent that details the maternal and fetal risks involved with the procedure

Exclusion criteria

Exclusion Criteria:

  • Contraindication to abdominal surgery, fetoscopic surgery, or general anesthesia
  • Allergy or previous adverse reaction to a study medication specified in this protocol
  • The patient does not fulfill the conventional criteria to undergo in-utero surgery, which is specific for each surgery
  • Preterm labor, preeclampsia, or a uterine anomaly (e.g., large fibroid tumor) that is unavoidable during surgery in the index pregnancy
  • Fetal aneuploidy, genomic variants of known significance if an amniocentesis has been performed, other major fetal anomalies or disorders that may impact the fetal/neonatal survival, or a known syndromic mutation
  • Suspicion of a major recognized syndrome by ultrasound or MRI
  • Maternal BMI >40 kg/m2
  • High risk for fetal hemophilia
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Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
160 participants (estimated)

Study arms

  • Experimental
    KARL STORZ Curved Scope

    Device: Curved KARL STORZ fetoscope

  • Active comparator
    Conventional scopes

    Device: Conventional Scopes

Interventions

  • DeviceCurved KARL STORZ fetoscope

    The KARLZ STORZ curved scope is used to see the inside of a pregnant person's uterus during minimally invasive surgery, similar to conventional scopes. The curved scope is rounded and thought to help visualize the anterior placenta because of its position on the uterus.

  • DeviceConventional Scopes

    The conventional scopes are regularly used during laser photocoagulation of placental anastomoses.

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What researchers measure

Primary outcomes

  1. Operative time in minutes

    Time from from operative cannula insertion until it is removed

    Time frame: during surgery

Secondary outcomes

  1. Number of Participants that have a gestational age of less than 37 weeks

    Time frame: at time of delivery (about 20 weeks from surgery)

  2. Number of times additional fetoscopes are entered into the amniotic cavity to confirm completion of the in-utero intervention

    Time frame: end of surgery (about 60 minutes after start of surgery)

  3. Total number of procedures with completion of the laser ablation

    Time frame: end of surgery (about 60 minutes after start of surgery)

  4. Improved visualization as assessed by the Likert scale

    This is reported categorically as strongly disagree, disagree, neither agree not disagree, agree and strongly agree. This is not a validated scale and does not have an official title. The minimum value is strongly disagree and the maximum value is strongly agree. Higher scores mean better outcomes.

    Time frame: end of surgery (about 60 minutes after start of surgery)

  5. Improved angle for laser visualization as assessed by the Likert scale

    This is reported categorically as strongly disagree, disagree, neither agree not disagree, agree and strongly agree

    Time frame: end of surgery (about 60 minutes after start of surgery)

  6. Total number of fetuses alive, after the laser photocoagulation procedure

    Time frame: at discharge from hospital (about 24 hours after surgery)

  7. Total number of maternal patients that present with morbidity

    Time frame: at discharge from hospital (about 24 hours after surgery)

  8. Total number of patients that have maternal and/or fetal perioperative complications

    Time frame: end of surgery (about 60 minutes after start of surgery)

  9. The number of participants that develop twin-anemia-polycythemia sequence (TAPS)

    Time frame: end of surgery (about 60 minutes after start of surgery)

  10. Number of live births

    Time frame: at time of delivery (about 20 weeks from surgery)

  11. Number of neonates with a short-term morbidity

    Time frame: from birth until hospital discharge

  12. Infant development score using the Ages & Stages Questionnaires, Third Edition (ASQ-3)

    Scored items on ASQ-3 address 5 areas of child development: communication, gross motor, Fine motor, problem solving, and personal-social and each of these have 6 questions each and is scored as yes( 10 points), sometimes (5 points) and not yet (0 points)-the total score is calculated for each area and scores should fall between 0-60, and a higher score indicates more development. There is a 9 item overall developmental section that is answered categorically as yes or no answer

    Time frame: 24 months of age

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Study locations

1 site
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References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

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Registry details

Key details

Study ID
NCT06084247
Lead sponsor
Jimmy Espinoza
Responsible party
Jimmy Espinoza (Professor, The University of Texas Health Science Center, Houston) — Sponsor-investigator
First posted
Oct 16, 2023
Start date
Sep 1, 2025 (estimated)
Primary completion
Nov 1, 2026 (estimated)
Completion
Dec 1, 2027 (estimated)
Last update
Aug 14, 2025

Study contacts

Jimmy Espinoza, MD, MSc,FACOG
Contact
Jimmy.Espinoza@uth.tmc.edu
(713) 500-5859
Elisa Garcia
Contact
Elisa.I.Garcia@uth.tmc.edu
713-500-6347
Jimmy Espinoza, MD, MSc,FACOG
principal investigator · The University of Texas Health Science Center, Houston

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

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This study is not yet recruiting, as verified in Aug 2025. You cannot join it, but the record below documents what was studied.

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