Guidelines for diagnosis, treatment, and use of laparoscopy for surgical problems during pregnancy

Surgeons, Endoscopic; Hori, Yumi

doi:10.1007/s00464-008-9758-6

Cited by 146 publications

(61 citation statements)

References 149 publications

(176 reference statements)

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“…The second trimester is the safest period to do surgery during pregnancy because of the risk of spontaneous abortion in the first trimester (58). In patients in whom the tumor is diagnosed after 24 weeks of gestation, the patient can be treated for a prolonged period, using the same drugs that are used for presurgical preparation, until the fetus is viable.…”

Section: How To Localize the Tumor During Pregnancy?mentioning

confidence: 99%

ENDOCRINE DISORDERS IN PREGNANCY: Pheochromocytoma and pregnancy: a deceptive connection

Lenders¹

2012

European Journal of Endocrinology

135

139

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A pheochromocytoma in a pregnant patient is one of the most threatening medical conditions for mother, fetus, and physician. Although extraordinarily rare with a frequency of 0.002% of all pregnancies, this tumor is notorious for its devastating consequences. As in non-pregnant patients, the signs and symptoms are quite variable but not specific, with hypertension being one of the most prominent signs. Confusion with the much more prevalent forms of pregnancy-related hypertension is the main cause of overlooking the diagnosis. If undiagnosed, maternal and fetal mortality is around 50%. Conversely, early detection and proper treatment during pregnancy decrease the maternal and fetal mortality to !5 and 15% respectively. For the biochemical diagnosis, plasma or urinary metanephrines are the tests of first choice since they have a nearly maximal negative predictive value. For reliable localization, only magnetic resonance imaging is suitable, with a sensitivity of more than 90%. When the tumor is diagnosed in the first 24 weeks of gestation, it should be removed by laparoscopic adrenalectomy after 10-14 days of medical preparation with the same drugs as in non-pregnant patients. If the tumor is diagnosed in the third trimester, the patient should be managed until the fetus is viable using the same drug regimen as for regular surgical preparation. Cesarean section with tumor removal in the same session or at a later stage is then preferred since vaginal delivery is possibly associated with higher mortality. Despite all technical diagnostic and therapeutic progress over the last decades, the key factor for further reduction of maternal and fetal mortality is early awareness and recognition of the potential presence of a pheochromocytoma in a pregnant patient with hypertension.

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Section: How To Localize the Tumor During Pregnancy?mentioning

confidence: 99%

ENDOCRINE DISORDERS IN PREGNANCY: Pheochromocytoma and pregnancy: a deceptive connection

Lenders¹

2012

European Journal of Endocrinology

135

139

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“…After many of the above listed studies were published in the past 10 years, SAGES revised their guidelines in 2007 (Table 4). 25 New guidelines include; operating during any trimester in pregnancy can be safely performed, intraoperative CO 2 monitoring should be performed by capnography, and entry technique by Veress needle, open (Hasson), or optical trocar can be safely performed. Regarding entry technique, this is dependent on the surgeon's experience and placement of initial trocar should be adjusted according to fundal height.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopy in Pregnancy

Chohan

Kilpatrick

2009

Clinical Obstetrics &Amp; Gynecology

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The first laparoscopic surgery in pregnancy was a cholecystectomy in 1991. Since that time, a number of articles and case series have been published addressing laparoscopy in pregnancy. Current recommendations are on the basis of these findings, such as operating during any trimester in pregnancy can be safely performed, fetal heart monitoring should be made preoperatively and postoperatively, prophylactic tocolytics should not be used, and multiple entry techniques (Veress needle, Hasson trocar, or optical trocar) can be safely performed. This article will review anesthesia, fetal effects, obesity, complications, adnexal masses, and gastrointestinal issues.

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“…According to the ''Guidelines for Diagnosis, Treatment, and Use of Laparoscopy for Surgical Problems During Pregnancy,'' released by the Society of the American Gastrointestinal and Endoscopic Surgeons in September 2007, if the site of initial abdominal access is adjusted according to fundal height and the abdominal wall is elevated during insertion, both the Hasson technique and Veress needle can be used safely and effectively (16).…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic management of complicated adnexal masses in the first trimester of pregnancy

Lai

Chen

2009

Fertility and Sterility

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Guidelines for diagnosis, treatment, and use of laparoscopy for surgical problems during pregnancy

Cited by 146 publications

References 149 publications

ENDOCRINE DISORDERS IN PREGNANCY: Pheochromocytoma and pregnancy: a deceptive connection

ENDOCRINE DISORDERS IN PREGNANCY: Pheochromocytoma and pregnancy: a deceptive connection

Laparoscopy in Pregnancy

Laparoscopic management of complicated adnexal masses in the first trimester of pregnancy

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