The use of laparoscopic surgery in pregnancy: evaluation of safety and efficacy

doi:10.1016/j.amjsurg.2009.09.022

The American Journal of Surgery

Volume 200, Issue 3, September 2010, Pages 363-367

This study was presented at the 2008 meeting of the Southwest Surgical Society.

https://doi.org/10.1016/j.amjsurg.2009.09.022 Get rights and content

Abstract

Background

Laparoscopic surgery in pregnant women has become increasingly more common since the 1990s; however, the safety of laparoscopy in this population has been widely debated, particularly in emergent and urgent situations.

Methods

A retrospective chart review of all pregnant women following a nonobstetric abdominal operation at a University hospital between 1993 and 2007. Perioperative morbidity and mortality for the mother and fetus were evaluated.

Results

Ninety-four subjects were identified; 53 underwent laparoscopic procedures and 41 underwent open procedures. Cholecystectomy and appendectomy were performed in both groups with salpingectomy/ovarian cystectomy only in the laparoscopic group. No maternal deaths occurred, while fetal loss occurred in 3 cases within 7 days of the operation and in 1 case 7 weeks postoperatively. This and other perinatal complications occurred in 36.7% of the laparoscopic group and 41.7% of the open group.

Conclusion

Laparoscopic appendectomy and cholecystectomy appear to be as safe as the respective open procedures in pregnant patients; however, this population in particular remains at risk for perinatal complications regardless of the method of abdominal access.

Section snippets

Methods

This study was conducted as a single-center retrospective review of all pregnant women who underwent a nonobstetric abdominal procedure between January 1, 1993 and June 30, 2007. This study was approved by the Institutional Review Board of the University of Texas Health Science Center at San Antonio (UTHSCSA).

Subjects were identified through a query of the University Hospital Medical Records for all ICD-9 and CPT codes with modifiers for pregnancy coinciding with a nonobstetric abdominal

Results

A total of 94 subjects were identified (Table 1). Of these, 53 underwent laparoscopic procedures and 41 underwent open procedures. Laparoscopic procedures included appendectomy, cholecystectomy, and salpingectomy/ovarian cystectomy; open procedures included appendectomy and cholecystectomy. Postoperative lengths of stay were not significantly different between groups. Most both the laparoscopic and open procedures were performed in either the first or second trimester of pregnancy. There was a

Comments

The advantages of laparoscopic procedures over open procedures in the general population are well described. These include reduced postoperative pain, shorter length of hospital stay, a decreased incidence of thromboembolic events, faster recovery, improved cosmesis, and decreased rates of postoperative ileus.¹² For these reasons, laparoscopy has become the preferred method for many surgical procedures, including cholecystectomy and appendectomy. Despite this, some surgeons are reluctant to

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Clinical scienceThe use of laparoscopic surgery in pregnancy: evaluation of safety and efficacy

Abstract

Background

Methods

Results

Conclusion

Section snippets

Methods

Results

Comments

J Am Assoc Gynecol Laparosc

Am J Surg

Surg Clin North Am

J Am Assoc Gynecol Laparoscopy

Med Clin North Am

Surg Clin North Am

Medicine

The effect of non-obstetric operations during pregnancy

Surg Gynecol Obstet

Laparoscopic surgery during pregnancy is safe for both mother and fetus

J Gastrointest Surg

Clinical science
The use of laparoscopic surgery in pregnancy: evaluation of safety and efficacy