Laparoscopic surgery in pregnancy

Abstract

A 32-year-old white lady suffering from tubal infertility was referred to our institution in November 1992 because of low abdominal pain due to a heterotopic pregnancy (one intrauterine sac and the other in the right tube). The patient had undergone, 8 weeks before, her second successful attempt at in vitro fertilization and embryo transfer. We decided to perform a laparoscopic salpingectomy. At inspection, the presence of tubo-ovarian adhesions was noted, secondary to the previous tubal microsurgical procedure, that were lysed by means of monopolar electrocoagulation. Salpingectomy was performed by combined bipolar cauterization and blunt-scissor dissection of the mesosalpinx. No uterine contractions were noted after surgery and the patients were discharged the next day. The rest of the pregnancy was uneventful and the patient spontaneously delivered vaginally a healthy female newborn weighing 3,060 g (Apgar score = 9) on June 20, 1993, at 39 weeks of gestation. A review of the published literature on laparoscopic surgery in pregnancy is given.

Pregnancy: A Contraindication?

“…Another limitation is the risk of anesthesia in general. [31] 1991 1 Excellent Bennet [32] 1993 1 Excellent Chandra [33] 1994 1 Excellent Comitalo [34] 1994 4 Excellent Constantino [35] 1994 2 Excellent Csaba [36] 1994 1 Excellent Edelman [37] 1994 1 Excellent Elerding [38] 1993 5 Excellent Fabiani [39] 1993 1 Excellent Friedman [40] 1995 1 Excellent Gurbuz [41] 1997 15 Excellent Hart [42] 1993 3 Excellent Jackson [43] 1993 1 Excellent Lang [44] 1995 2 Excellent Lemaire [45] 1997 7 Excellent Martin [46] 1996 3 Excellent Morrell [47] 1992 5 Excellent Pucci [48] 1991 1 Excellent Remorgida [49] 1995 1 Excellent Rusher [50] 1993 1 Excellent Schorr [51] 1993 2 Excellent Schreiber [52] 1990 6 Excellent Shaked [53] 1994 1 Excellent Soper [54] 1992 5 Excellent Spirtos [55] 1987 13 Excellent Steinbrook [56] 1996 10 Excellent Weber [57] 1991 1 Excellent Wilson [58] 1994 2 Excellent Wishner [59] 1996 6 Excellent The literature gives various detailed recommendations for the performance of laparoscopic procedures during pregnancy [31,47,48,54,55,60]: Pneumatic compression devices for lower extremities can be used because of the increased risk of thromboembolic disease. The operating table should be rotated to the left to displace the uterus from the inferior vena cava.…”