Laparoscopy in Pregnancy

Abstract

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.

Placenta Percreta-Induced Uterine Rupture Diagnosed By Laparoscopy in the First Trimester

“…Thereafter, laparoscopy has been widely used in pregnant women for the differential diagnosis of acute abdomen such as appendicitis, cholecystitis, or adnexal masses 15. In addition, laparoscopic surgery during pregnancy is regarded safe 14, 16. Hence, in vague and emergent conditions, such as in the case of our patient, laparoscopy can be helpful for the early diagnosis of hemoperitoneum due to uterine rupture.…”

“…The gradual increase in the size of the uterus with advancing pregnancy can cause a delay in the diagnosis and appropriate treatment. The first laparoscopic surgery during pregnancy was cholecystectomy, performed in 1991 14. Thereafter, laparoscopy has been widely used in pregnant women for the differential diagnosis of acute abdomen such as appendicitis, cholecystitis, or adnexal masses 15.…”

A review on pregnancy complicated by ovarian epithelial and non-epithelial malignant tumors: Diagnostic and therapeutic perspectives

“…However, there is a lack of data to support a benefit of the use of tocolytic agents for pregnant women with non-obstetric surgery during pregnancy [26] . A systemic review failed to demonstrate positive effects of the routine use of prophylactic tocolytics for pregnant women who need non-obstetric surgery during pregnancy [27] . By contrast, their use should be reserved for circumstances in which evidence of preterm labor is apparent [27] .…”

“…A systemic review failed to demonstrate positive effects of the routine use of prophylactic tocolytics for pregnant women who need non-obstetric surgery during pregnancy [27] . By contrast, their use should be reserved for circumstances in which evidence of preterm labor is apparent [27] . The patient should be placed in left lateral oblique position prior to induction of anaesthesia, with the prospect of improving uterine blood flow and preventing inferior vena cava compression and supine hypotension syndrome [11] .…”

Perforation of the Pregnant Uterus during Laparoscopy for Suspected Internal Herniation after Gastric Bypass

“…Open access for laparoscopy and intraoperative ultrasonography to ensure the location of the uterus fundus should be considered in pregnancy, perhaps especially in obese women. Veress needle should be used with caution in the second and third trimesters [ 4 ]. The use of Veress needle would probably also have lacerated the uterus in our patient due to the very high location of the uterus in the subcostal region.…”