Our Summary

The most common surgical issue during pregnancy is acute appendicitis. A popular and minimally invasive treatment for this issue is Laparoscopic Appendectomy (LA). However, when done during the last three months of pregnancy, LA can be technically challenging and could risk premature birth and even the loss of the baby. In a study from 2011 to 2016, three cases of LA in the last three months of pregnancy were successfully performed without complications or loss of the baby. To compare with other studies, researchers looked at medical literature from 2007 to 2016 and found 6 reports with 17 cases. In these cases, around 12% needed to change to a more traditional surgery, about 7% had complications, and 20% resulted in premature birth. However, none of these cases resulted in the loss of the baby. This study shows that LA could be a viable treatment for appendicitis in the last three months of pregnancy.

FAQs

  1. What is the most common surgical issue during pregnancy?
  2. What are the potential risks of Laparoscopic Appendectomy (LA) during the last three months of pregnancy?
  3. What were the findings of the study about LA performed in the last three months of pregnancy from 2011 to 2016?

Doctor’s Tip

One helpful tip a doctor might tell a patient about laparoscopic appendectomy is to discuss the risks and benefits with them thoroughly before making a decision. It’s important to weigh the potential risks of premature birth and other complications against the benefits of a minimally invasive surgery. It’s also important to choose a skilled and experienced surgeon who has experience performing laparoscopic surgeries during pregnancy. Additionally, it’s important to closely monitor the pregnancy and have a plan in place in case there are any complications during or after the surgery. Overall, open communication with your healthcare provider and being well-informed about your options is key in making the best decision for you and your baby.

Suitable For

Patients who are typically recommended for laparoscopic appendectomy include:

  • Patients with uncomplicated appendicitis
  • Patients who are not in their third trimester of pregnancy
  • Patients who are not at high risk for complications during surgery
  • Patients who are in overall good health and able to tolerate the procedure
  • Patients who prefer a minimally invasive approach to surgery
  • Patients who have a surgeon experienced in performing laparoscopic appendectomies

Timeline

Before Laparoscopic Appendectomy:

  1. Patient experiences symptoms of appendicitis such as abdominal pain, nausea, vomiting, and fever.
  2. Patient seeks medical attention and undergoes physical examination, blood tests, and imaging studies to diagnose appendicitis.
  3. Surgery is recommended as the treatment option for appendicitis.
  4. Patient is informed about the risks and benefits of laparoscopic appendectomy.

During Laparoscopic Appendectomy:

  1. Patient is prepared for surgery, which involves anesthesia and positioning on the operating table.
  2. Surgeon makes small incisions in the abdomen and inserts a laparoscope and other surgical instruments.
  3. Surgeon removes the inflamed appendix through the small incisions.
  4. Surgery typically takes about 30-45 minutes to complete.
  5. Patient is closely monitored in the recovery room before being transferred to a regular hospital room.

After Laparoscopic Appendectomy:

  1. Patient may experience some pain and discomfort at the incision sites.
  2. Patient is encouraged to walk and move around to aid in the healing process.
  3. Patient may be discharged from the hospital within 24-48 hours after surgery.
  4. Patient is advised to follow post-operative care instructions, including taking pain medication, watching for signs of infection, and avoiding strenuous activities.
  5. Patient has follow-up appointments with the surgeon to ensure proper healing and recovery.

What to Ask Your Doctor

  1. What are the potential risks and benefits of having a laparoscopic appendectomy during pregnancy?

  2. How experienced are you in performing laparoscopic appendectomies on pregnant patients?

  3. Are there any specific precautions or considerations that need to be taken during the surgery due to my pregnancy?

  4. What is the likelihood of needing to convert to a more traditional surgery during the procedure?

  5. How will the surgery and anesthesia affect my baby?

  6. What is the expected recovery time and potential impact on my pregnancy?

  7. Are there any long-term effects or risks associated with having a laparoscopic appendectomy during pregnancy?

  8. What alternative treatment options are available and how do they compare to laparoscopic appendectomy in terms of safety and effectiveness?

  9. Will I need any follow-up care or monitoring after the surgery to ensure the health of my baby and myself?

  10. Can you provide me with any additional information or resources to help me make an informed decision about proceeding with a laparoscopic appendectomy during pregnancy?

Reference

Authors: Iwamura S, Hashida H, Yoh T, Kitano S, Mizumoto M, Kitamura K, Kondo M, Kobayashi H, Kaihara S, Hosotani R. Journal: Asian J Endosc Surg. 2018 Nov;11(4):413-416. doi: 10.1111/ases.12456. Epub 2018 Jan 4. PMID: 29314749