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Surgical Endoscopy

, Volume 22, Issue 9, pp 1917–1927 | Cite as

Diagnosis and laparoscopic treatment of surgical diseases during pregnancy: an evidence-based review

  • Heidi Jackson
  • Steven Granger
  • Raymond PriceEmail author
  • Michael Rollins
  • David Earle
  • William Richardson
  • Robert Fanelli
Review

Abstract

Treatment of surgical disease in the gravid patient requires a unique and careful approach where safety of the mother and fetus are both considered. Approaches to diagnosis and therapy of surgical disease in the gravid patient are increasingly clarified and defined in the literature. Laparoscopy, once described as contraindicated in pregnancy, has been steadily accepted and applied as data supporting its safety and use have accumulated. An extensive review of the literature was performed to define the use of laparoscopy in pregnancy. Diagnoses for independent surgical diseases as well as imaging modalities and techniques during pregnancy are reviewed. Preoperative, intraoperative, and postoperative management of the pregnant patient are described and evaluated with focus on use of laparoscopy. Literature supporting safety and efficacy of laparoscopy in cholecystectomy, appendectomy, solid organ resection, and oophorectomy in the gravid patient is outlined. Based on level of evidence, this review includes recommendations specific to surgical approach, trimester of pregnancy, patient positioning, port placement, insufflation pressure, monitoring, venous thromboembolic prophylaxis, obstetric consultation, and use of tocolytics in the pregnant patient.

Keywords

Laparoscopy Pregnancy Cholecystectomy Appendectomy Guidelines Radiology 

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Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Heidi Jackson
    • 1
  • Steven Granger
    • 1
  • Raymond Price
    • 2
    Email author
  • Michael Rollins
    • 3
  • David Earle
    • 4
  • William Richardson
    • 5
  • Robert Fanelli
    • 6
  1. 1.Department of SurgeryUniversity of Utah Medical CenterSalt Lake CityUSA
  2. 2.Department of SurgeryIntermountain Medical Center, Intermountain HealthcareSalt Lake CityUSA
  3. 3.Department of SurgeryPrimary Children’s Medical Center, Intermountain HealthcareSalt Lake CityUSA
  4. 4.Department of SurgeryBaystate Medical CenterSpringfieldUSA
  5. 5.Department of SurgeryOchsner Clinic FoundationNew OrleansUSA
  6. 6.Department of SurgeryBerkshire Medical CenterPittsfieldUSA

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