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

Corneille, Michael G.; Gallup, Theresa M.; Bening, Thomas; Wolf, Steven E.; Brougher, Caitlin; Myers, John G.; Dent, Daniel L.; Medrano, Gabriel; Xenakis, Elly; Stewart, Ronald M.

doi:10.1016/j.amjsurg.2009.09.022

« Previous Next »The American Journal of Surgery
Volume 200, Issue 3 , Pages 363-367, September 2010

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

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

Michael G. Corneille, M.D.
- Department of Surgery, Division of Trauma and Emergency Surgery, University of Texas, Health Science Center, San Antonio, TX, USA
- Corresponding author. Tel.: +1 210 567 3623; fax: +1 210 567 3623
Theresa M. Gallup, M.D.
- Department of Surgery, Division of Trauma and Emergency Surgery, University of Texas, Health Science Center, San Antonio, TX, USA
Thomas Bening, M.D.
- Department of Surgery, Division of Trauma and Emergency Surgery, University of Texas, Health Science Center, San Antonio, TX, USA
Steven E. Wolf, M.D.
- Department of Surgery, Division of Trauma and Emergency Surgery, University of Texas, Health Science Center, San Antonio, TX, USA
Caitlin Brougher, B.S., E.M.T.
- Department of Surgery, Division of Trauma and Emergency Surgery, University of Texas, Health Science Center, San Antonio, TX, USA
John G. Myers, M.D.
- Department of Surgery, Division of Trauma and Emergency Surgery, University of Texas, Health Science Center, San Antonio, TX, USA
Daniel L. Dent, M.D.
- Department of Surgery, Division of Trauma and Emergency Surgery, University of Texas, Health Science Center, San Antonio, TX, USA
Gabriel Medrano, M.D.
- Department of Obstetrics and Gynecology, University of Texas, Health Science Center, San Antonio, TX, USA
Elly Xenakis, M.D.
- Department of Obstetrics and Gynecology, University of Texas, Health Science Center, San Antonio, TX, USA
Ronald M. Stewart, M.D.
- Department of Surgery, Division of Trauma and Emergency Surgery, University of Texas, Health Science Center, San Antonio, TX, USA

Received 2 May 2009; received in revised form 17 August 2009

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.

Keywords: Laparoscopy, Pregnancy, Surgery, Appendicitis, Cholecystitis, Pregnancy outcome