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

Am J Surg. 2010 Sep;200(3):363-7. doi: 10.1016/j.amjsurg.2009.09.022.

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.

MeSH terms

  • Adult
  • Appendectomy / methods
  • Chi-Square Distribution
  • Cholecystectomy, Laparoscopic / methods
  • Fallopian Tubes / surgery
  • Female
  • Humans
  • Laparoscopy*
  • Ovarian Cysts / surgery
  • Pregnancy
  • Pregnancy Complications / surgery*
  • Retrospective Studies
  • Safety
  • Treatment Outcome