Safety and outcome of general surgical open and laparoscopic procedures during pregnancy

Abstract

Reviewing our results and the available literature, we believe that the outcome of surgery during pregnancy is not dictated by the type of procedure but by the type of disease. The gain for fetal outcome in the future most likely lies in the diagnostic pathway rather than the type of surgery.

Laparoscopic versus open cholecystectomy in pregnancy: a systematic review and meta-analysis

“…Surgery was usually delayed until the second trimester which was thought to be the safest of all trimesters with a lower risk of miscarriage and anesthetic risk to the fetus with the additional benefit of operating in an abdomen without an overbearingly large gravid uterus [4,9,17]. Results from this meta-analysis reflect this approach with the majority of cholecystectomies (63.4 %) performed during the second trimester.…”

“…One study was excluded as it reported combined outcomes for cholecystectomies, appendectomy and diagnostic laparoscopies [15]. Two other studies were excluded as they reported combined laparoscopic and open cholecystectomies and appendectomy without a comparator OC group [16,17].…”

Non-operative Management of Symptomatic Cholelithiasis in Pregnancy is Associated with Frequent Hospitalizations

“…In most case series, no complications are reported. The technical aspects of laparoscopic surgery including increased intra-abdominal pressure and the insufflation of carbon dioxide have been studied in animal models and have not been shown to cause negative maternal or fetal outcomes during pregnancy [7][8][9][10][11][12]. Recent studies have shown that antepartum LC may limit subsequent complications from gallstone disease [ 13 ].…”

“…It was also recommended that cholecystectomy only be performed in the 2nd trimester if this operation was deemed necessary due to the estimated lowest risks of premature labor and spontaneous abortion. However, more recently, laparoscopic cholecystectomy (LC) has been shown to be safe and effective throughout pregnancy [7][8][9] ]. There are no large prospective studies addressing the safety of LC in pregnancy, but multiple retrospective case series and reviews, including studies by De Bakker et al in 2010 andRizzo in 2003, reveal very low rates of complications such as premature delivery and fetal death.…”

Management of Acute Appendicitis in Pregnancy

“…[1,[16][17][18] Laparoscopy is associated with decreased hospital stay, quicker return of bowel function, less postoperative pain, and smaller chance of wound infection and hernia. [3,19] Hasson trocar and Veress needle can be used for insufflation; however, we preferred open technique for first trocar insertion in eight patients.…”