[Laparoscopic appendicectomy and pregnancy. Personal experience and review of the literature].
BACKGROUND
Pregnancy has been considered to be an absolute contraindication to the laparoscopic approach because of the theoretical effects of the pneumoperitoneum on the fetus and the occupation of the working space by the gravid uterus. Despite the growing literature on the subject, experience with frequent entities, such as acute appendicitis, is limited.


OBJECTIVE
The aim of this study was to report our experience with laparoscopic appendicectomy in pregnancy, to review the scientific evidence available on the safety of this procedure, and to establish the most relevant practical features for the use of this approach during pregnancy.


METHODS
We retrospectively reviewed six laparoscopic appendectomies performed in pregnant women. We also reviewed the available literature on well documented laparoscopic appendectomies during pregnancy.


RESULTS
All the procedures were laparoscopically completed. The mean operating time was 46 min. All patients were discharged within the first 48 postoperative hours. There were no surgical complications. All patients delivered healthy infants with appropriate weight for gestational age. For the literature review, 17 references were collected that included data on 94 laparoscopic appendectomies performed in pregnant women. There was only one fetal death associated with the surgical approach and the overall fetal mortality rate was less than that classically registered in the literature for the open approach.


CONCLUSIONS
Laparoscopic appendectomy in pregnant women is as safe and effective as the open approach and confers all the benefits of minimally invasive surgery.
Moreno-Sanz
Carlos
C
Servicio de Cirugía General, Complejo Hospitalario La Mancha-Centro, Alcázar de San Juan, Ciudad Real, Spain. drmoreno@laparoscopia-online.com
Pascual-Pedreño
Ana
A
Picazo-Yeste
Joaquín
J
Corral-Sánchez
Miguel Angel
MA
Marcello-Fernández
Manuel
M
Seoane-González
José
J
D000208:Acute Disease; D000328:Adult; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery*; D012189:Retrospective Studies