Our Summary

This research paper looks at the outcomes of laparoscopic surgeries (a type of minimally invasive surgery using small incisions) performed during different stages of pregnancy. The researchers looked back at the medical records of 117 pregnant women who underwent this type of surgery between 1996 and 2013. They divided the women into two groups: those who had surgery in the first three months of pregnancy, and those who had surgery in the second and third trimesters.

They found that different types of surgeries were more common in the two groups. For example, surgery for adnexal torsion (a condition where the ovary twists around the tissues that support it) was more common in the first group, while surgery for cholecystitis (inflammation of the gallbladder) and persistent ovarian masses were more common in the second group.

The time between admission to the hospital and surgery was also longer for the second group compared to the first group. However, there was no difference found between the two groups in terms of surgical complications, the findings from tissue samples taken during surgery, and pregnancy outcomes.

In conclusion, the researchers state that, based on their findings, laparoscopic surgery during the later stages of pregnancy appears to be as safe and feasible as during the early stages of pregnancy, without any negative effects on the outcome of the pregnancy.

FAQs

  1. Is laparoscopic surgery safe to perform during advanced pregnancy?
  2. What are the common reasons for undergoing laparoscopic surgery during early and advanced pregnancy?
  3. Were there any differences in surgical complications and pregnancy outcomes between early and advanced pregnancy laparoscopic surgeries?

Doctor’s Tip

One helpful tip a doctor might tell a patient about laparoscopic surgery is to discuss the timing of the surgery with their healthcare provider. In some cases, it may be safe to undergo laparoscopic surgery during advanced pregnancy, as long as the benefits outweigh the risks. It is important to consider the specific circumstances of each individual case and weigh the potential benefits and risks before proceeding with surgery.

Suitable For

Patients who are typically recommended for laparoscopic surgery include those with conditions such as adnexal torsion, cholecystitis, persistent ovarian mass, ectopic pregnancy, appendicitis, endometriosis, and ovarian cysts. The decision to perform laparoscopic surgery during pregnancy should be carefully considered by a multidisciplinary team and weighed against the potential risks and benefits to both the mother and the fetus. In some cases, laparoscopic surgery may be preferred over open surgery due to its minimally invasive nature and shorter recovery time. It is important for patients to discuss their options with their healthcare provider and make an informed decision based on their individual circumstances.

Timeline

Before laparoscopic surgery:

  • Patient presents with symptoms requiring surgical intervention, such as adnexal torsion, cholecystitis, or ovarian mass
  • Diagnostic tests are performed to confirm the need for surgery
  • Patient is scheduled for laparoscopic surgery
  • Pre-operative consultations and preparations are conducted, including anesthesia evaluation and consent forms

After laparoscopic surgery:

  • Patient undergoes laparoscopic surgery, which is performed successfully without conversion to laparotomy
  • Patient is monitored post-operatively for any complications
  • Patient is discharged from the hospital within a few days, depending on the type of surgery
  • Follow-up appointments are scheduled to monitor recovery and pregnancy outcomes
  • Pregnancy outcomes are assessed and found to be comparable between patients who underwent surgery in early pregnancy and in advanced pregnancy.

What to Ask Your Doctor

  1. What specific risks or complications are associated with laparoscopic surgery during pregnancy?
  2. How will anesthesia be administered during the surgery and how will it affect the baby?
  3. How will the surgery affect the baby’s development and growth?
  4. Will the surgery have any impact on the pregnancy itself, such as risk of preterm labor or miscarriage?
  5. What is the recovery process like after laparoscopic surgery during pregnancy?
  6. How will the surgery affect future pregnancies or fertility?
  7. Are there any restrictions or precautions I should take after the surgery?
  8. How will the surgery be performed to ensure the safety of both me and my baby?
  9. Will the surgery require any additional monitoring or follow-up during the remainder of the pregnancy?
  10. What are the alternative treatment options available for my condition during pregnancy?

Reference

Authors: Weiner E, Mizrachi Y, Keidar R, Kerner R, Golan A, Sagiv R. Journal: Arch Gynecol Obstet. 2015 Nov;292(5):1063-8. doi: 10.1007/s00404-015-3744-8. Epub 2015 May 10. PMID: 25958071