Laparoscopic surgery performed in advanced pregnancy compared to early pregnancy

Weiner, Eran; Mizrachi, Yossi; Keidar, Ran; Kerner, Ram; Golan, Abraham; Sagiv, Ron

doi:10.1007/s00404-015-3744-8

Cited by 55 publications

(47 citation statements)

References 22 publications

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“…Ameliyat üçüncü trimesterde gerekli olduğunda, genişlemiş uterus yeterli görüntü elde etmeyi engelleyebilir. Ancak, apendisit, kolesistit, invajinasyon ve adneksiyal kitle nedeniyle yapılan başarılı laparoskopik yönetim gebeliğin 34. haftasına kadar yapılabilir (19)(20)(21)(22)(23)(24)(25). Laparoskopik prosedürün üçüncü trimesterde uygulanabilir olup olmadığı bireysel klinik faktörlere bağlıdır.…”

Section: Zamanlamaunclassified

Laparoscopic Surgery in Pregnat Women (Review)

Külhan¹,

Kulhan²,

Ulug³

2017

Van Med J

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Section: Zamanlamaunclassified

Laparoscopic Surgery in Pregnat Women (Review)

Külhan¹,

Kulhan²,

Ulug³

2017

Van Med J

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“…complicaciones quirúrgicas, hallazgos histopatológicos y resultados del embarazo. 9 Otro aspecto importante a tener en cuenta durante la laparoscopía durante el embarazo es el manejo de la presión intra-abdominal la cual se sugiere mantenerla preferiblemente por debajo de 12 mmHg y esto junto con un menor tiempo quirúrgico reduce el riesgo de hipercarbia materna y acidosis fetal. En un estudio de 2233 Laparoscopias 2491 Laparotomías en mujeres con embarazo único entre las 4 y 20 semanas, no se encontraron diferencias significativas en el peso al nacimiento, duración de la gestación, restricción del crecimiento, malformaciones fetales y muerte fetal.…”

Section: Introductionunclassified

Untitled

2017

Rev Med UAS

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ResumenIntroducción: El avance tecnológico, el mejor conocimiento de la fisiología del neumoperitoneo y las ventajas ya conocidas de la laparoscopía han permitido que pueda ser utilizada de forma segura durante el embarazo. Objetivo: Describir el manejo laparoscó-pico de un quiste gigante de ovario en el segundo trimestre del embarazo. Descripción del caso: Paciente en su segunda gestación la cual cursa con un embarazo de 18 semanas de con un producto único vivo y presencia de una masa anexial derecha, de contenido quístico. Se realiza bajo anestesia general con creación del acceso laparoscópico para colocación de trócar primario con técnica de Hasson (técnica abierta). A la introducción del lente se observa un útero gestante y una masa quística del ovario derecho que se extiende hasta el reborde costal derecho y hemidiafragma izquierdo. Se coagula con instrumento bipolar el bode anti-mesentérico del ovario, se incide corteza ovárica y se observa la salida de 4500 ml de líquido color ámbar. Se extrae el ovario por trocar accesorio con técnica en "reloj de arena", se reseca la capsula y el excedente de tejido ovárico. Se introduce de nuevo el ovario a cavidad y se verifica hemostasia. El manejo postoperatorio de la paciente fue a base de analgésicos y antibióticos, deambulación temprana. La paciente se egresa al día siguiente sin complicaciones. Conclusión: Este caso describe que la laparoscópica practicada durante la gestación es un procedimiento seguro, tanto para la madre como para el producto. La laparoscopía no está contraindicada durante el embarazo y sus ventajas son similares a las que tiene en no embarazadas. Se recomienda la técnica de abordaje abierto en e l segundo trimestre. Palabras clave: Embarazo, laparoscopia, masa anexial Abstract Introduction: Technological progress, better knowledge of the physiology of pneumoperitoneum and the advantages already known in laparoscopy have allowed it to be used safely during pregnancy. Objective: To describe the laparoscopic management of a giant ovarian cyst in the second trimester of pregnancy. Clinical case: Patient in the second pregnancy, who is 18 weeks of gestational age with a single live fetus and presence of a right adnexal mass with a cystic content. Under general anesthesia, we performed the laparoscopic access for placement of primary trocar with Hasson technique (open technique). During the laparoscopy we observed a pregnant uterus and a cystic mass of the right ovary that extends to the right costal ridge and left hemidiaphragm. The anti-mesenteric ovary buckle is clotted with a bipolar instrument and we performed a small cut in the ovarian cortex, and the outflow of 4500 ml of liquid is observed. The ovary is removed by changing the accessory with the "hourglass" technique, the capsule and part of ovarian tissue are dried. The ovary is again introduced into the abdominal cavity and hemostasis was performed. The postoperative management of the patient was based on analgesics and antibiotics and early ambulation. The patient is discharged the next...

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“…Lower postoperative thrombosis rate due to early mobilization associated with the laparoscopy is particularly of benefit to gravid patients, as pregnancy itself is a hypercoagulable state. 9 Overall PTL rate of 8 to 26% has been reported in patients underwent surgery during all trimesters of pregnancy for AT, but there is no specific data on PTL rate in 3rd trimester. 2,4,5,9 There is no evidence on prophylactic usage of tocolysis in the literature.…”

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confidence: 99%

“…9 Overall PTL rate of 8 to 26% has been reported in patients underwent surgery during all trimesters of pregnancy for AT, but there is no specific data on PTL rate in 3rd trimester. 2,4,5,9 There is no evidence on prophylactic usage of tocolysis in the literature. However perioperative usage should be considered in case of signs and symptoms suggesting preterm labor.…”

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confidence: 99%

“…Considerably longer presentation to surgery interval in the second and third trimester compared with the first trimester has been reported. 2,9 A correct diagnosis of ovarian torsion can be established by being acquainted with clinical findings of a patient who has relevant history, for instance infertility treatment or a history of adnexal mass, and integrating MRI with ultrasonography where necessary provided that feasible in emergency settings. If complete torsion with hemorrhagic necrosis is suspected, immediate surgery is needed.…”

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confidence: 99%

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Adnexal Torsion in the Third Trimester of Pregnancy: A Challenging Diagnosis

Tayyar¹,

Tayyar

Atakul

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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The incidence of adnexal torsion (AT) is reported 1 in 10000 births. AT is emergency condition in pregnancy, while the risk of late diagnosis is increased, in third trimester. Since it has been described as a severe complication after controlled ovarian hyper-stimulation for in vitro fertilization (IVF), it is more common in IVF pregnancies. This condition mainly occurs in the first trimester; it is rare during the late third trimester. Herein, we report a case of a 26-year-old woman, gravida 1, singleton pregnancy in the 30th week of gestation was presented to emergency department with 24-hour history of a stabbing pain because of AT. Removal of adnexa performed by laparotomy. The patient had labour pain and cervical dilatation at the 36th week of gestation and a healthy girl weighing 2,200 g was born by emergency caesarean section due to breech presentation.

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Laparoscopic surgery performed in advanced pregnancy compared to early pregnancy

Abstract: In our experience, laparoscopic surgery in advanced pregnancy was found to be feasible and safe as in early pregnancy, without any adverse effects on pregnancy outcome.

Cited by 55 publications

References 22 publications

Laparoscopic Surgery in Pregnat Women (Review)

Laparoscopic Surgery in Pregnat Women (Review)

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Adnexal Torsion in the Third Trimester of Pregnancy: A Challenging Diagnosis

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