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


CONCLUSIONS
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.
Corneille
Michael G
MG
Department of Surgery, University of Texas, Health Science Center, San Antonio, USA. corneille@uthscsa.edu
Gallup
Theresa M
TM
Bening
Thomas
T
Wolf
Steven E
SE
Brougher
Caitlin
C
Myers
John G
JG
Dent
Daniel L
DL
Medrano
Gabriel
G
Xenakis
Elly
E
Stewart
Ronald M
RM
D000328:Adult; D001062:Appendectomy / Q000379:methods; D016009:Chi-Square Distribution; D017081:Cholecystectomy, Laparoscopic / Q000379:methods; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy; D010048:Ovarian Cysts / Q000601:surgery; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery*; D012189:Retrospective Studies; D012449:Safety; D016896:Treatment Outcome