Skip to main content
SpringerLink
Log in

Robotic-assisted surgery for the treatment of pelvic masses in pregnant patients: a series of four cases and literature review

  • Original Article
  • Published:
Journal of Robotic Surgery Aims and scope Submit manuscript

Abstract

The purpose of this study was to assess the safety and feasibility of robotic-assisted surgery for the treatment of a pelvic mass in gravid patients. We retrospectively reviewed the charts of all pregnant women who were diagnosed with a pelvic mass by individual obstetric physicians and referred to our gynecologic oncology service from January 2009 until March 2012; four patients were identified and treated with robotic-assisted surgery by the same group of gynecologic oncologists. The following patient data were collected: age, disease origin, histology, tumor size, gravid status at surgery, surgical procedure, intra- and postoperative surgical complications, and both maternal and fetal outcomes. The gynecologic lesions comprised an immature teratoma, a mucinous cystadenoma, a hemorrhagic cyst and an ovarian endometrioma; in each case, blood loss was minimal and no maternal or fetal intra-operative complications were encountered. All patients had normal, spontaneous vaginal deliveries at term. Robotic-assisted surgery for the treatment of pelvic masses in pregnant patients is ostensibly feasible and associated with favorable outcomes for both the patient and fetus.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Latimer J (2007) Gynaecological malignancies in pregnancy. Curr Opin Obstet Gynecol 19:140–1404

    Article  PubMed  Google Scholar 

  2. Hunter MI, Monk BJ, Tewari KS (2008) Cervical neoplasia in pregnancy. Part 1: screening and management of pre-invasive disease. Am J Obstet Gynecol 199:3–9

    Article  PubMed  Google Scholar 

  3. Sherard GB 3rd, Hodson CA, Williams HJ et al (2003) Adnexal masses and pregnancy: a 12-year experience. Am J Obstet Gynecol 189:358–362

    Article  PubMed  Google Scholar 

  4. Morice P, Uzan C, Gouy S et al (2012) Gynaecological cancers in pregnancy. Lancet 379:558–569

    Article  PubMed  Google Scholar 

  5. Schmeler KM, Mayo-Smith WW, Peipert JF et al (2005) Adnexal masses in pregnancy: surgery compared with observation. Obstet Gynecol 105:1098–1103

    Article  PubMed  Google Scholar 

  6. Türkçüoğlu I, Meydanli MM, Engin-Ustün Y et al (2009) Evaluation of histopathological features and pregnancy outcomes of pregnancy associated adnexal masses. J Obstet Gynaecol 29:107–109

    Article  PubMed  Google Scholar 

  7. Zanotti KM, Belinson JL, Kennedy AW (2002) Treatment of gynecologic cancers in pregnancy. Semin Oncol 27:686–698

    Google Scholar 

  8. Amant F, Van Calsteren K, Halaska MJ et al (2009) Gynecologic cancers in pregnancy: guidelines of an international consensus meeting. Int J Gynecol Cancer 19(Suppl 1):S1–S12

    Article  PubMed  Google Scholar 

  9. Hess LW, Peaceman A, O’Brien WF et al (1988) Adnexal mass occurring with intrauterine pregnancy: report of fifty-four patients requiring laparotomy for definitive management. Am J Obstet Gynecol 158:1029–1034

    Article  PubMed  CAS  Google Scholar 

  10. Pittaway ED, Takacs P, Bauguess P (1994) Laparoscopic adnexectomy: a comparison with laparotomy. Am J Obstet Gynecol 171:385–391

    Article  PubMed  CAS  Google Scholar 

  11. Balthazar U, Steiner AZ, Boggess JF et al (2011) Management of a persistent adnexal mass in pregnancy: what is the ideal surgical approach? J Minim Invasive Gynecol 18:720–725

    Article  PubMed  Google Scholar 

  12. Hoover K, Jenkins TR (2011) Evaluation and management of adnexal mass in pregnancy. Am J Obstet Gynecol 205:97–102

    Article  PubMed  Google Scholar 

  13. Lin YH, Hwang JL, Huang LW et al (2003) Successful laparoscopic management of a huge ovarian tumor in the 27th week of pregnancy. A case report. J Reprod Med 48:834–836

    PubMed  Google Scholar 

  14. Phupong V, Bunyavejchewin S (2007) Gasless laparoscopic surgery for ovarian cyst in a second trimester pregnant patient with a ventricular septal defect. Surg Laparosc Endosc Percutan Tech 17:565–567

    Article  PubMed  Google Scholar 

  15. Mais V, Ajossa S, Piras B et al (1995) Treatment of nonendometriotic benign adnexal cysts: a randomized comparison of laparoscopy and laparotomy. Obstet Gynecol 86:770–774

    Article  PubMed  CAS  Google Scholar 

  16. Stepp KJ, Tulikangas PK, Goldberg JM et al (2003) Laparoscopy for adnexal masses in the second trimester of pregnancy. J Am Assoc Gynecol Laparosc 10:55–59

    Article  PubMed  Google Scholar 

  17. Bunyavejchevin S, Phupong V (2006) Laparoscopic surgery for presumed benign ovarian tumor during pregnancy. Cochrane Database Syst Rev 18:CD005459

    Google Scholar 

  18. Lambaudie E, Houvenaeghel G, Walz J et al (2008) Robot-assisted laparoscopy in gynecologic oncology. Surg Endosc 22:2743–2747

    Article  PubMed  Google Scholar 

  19. Fiorentino RP, Zepeda MA, Goldstein BH et al (2006) Pilot study assessing robotic laparoscopic hysterectomy and patient outcomes. J Minim Invasive Gynecol 13:60–63

    Article  PubMed  Google Scholar 

  20. Magrina JF, Zanagnolo VL (2008) Robotic surgery for cervical cancer. Yonsei Med J 49:879–885

    Article  PubMed  Google Scholar 

  21. Soliman PT, Frumovitz M, Sun CC et al (2011) Radical hysterectomy: a comparison of surgical approaches after adoption of robotic surgery in gynecologic oncology. Gynecol Oncol 123:333–336

    Article  PubMed  Google Scholar 

  22. Diaz-Arrastia C, Jurnalov C, Gomez G et al (2002) Laparoscopic hysterectomy using a computer-enhanced surgical robot. Surg Endosc 16:1271–1273

    Article  PubMed  CAS  Google Scholar 

  23. Beste TM, Nelson KH, Daucher JA (2005) Total laparoscopic hysterectomy utilizing a robotic surgical system. JSLS 9:133–135

    Google Scholar 

  24. Eichelberger KY, Cantrell LA, Balthazar U et al. (2012) Robotic resection of adnexal masses during pregnancy. Am J Perinatol (Epub ahead of print)

  25. Behtash N, Zarchi MK, Gilani MM et al (2008) Ovarian carcinoma associated with pregnancy: a clinicopathologic analysis of 23 cases and review of the literature. BMC Pregnancy Childbirth 8:3

    Article  PubMed  Google Scholar 

  26. Vincens C, Dupaigne D, de Tayrac R et al (2008) Management of pregnant women with advanced cervical cancer. Gynecol Obstet Fertil 36:365–372

    Article  PubMed  CAS  Google Scholar 

  27. Zhao XY, Huang HF, Lian LJ (2006) Ovarian cancer in pregnancy: a clinicopathologic analysis of 22 cases and review of the literature. Int J Gynecol Cancer 16:8–15

    Article  PubMed  CAS  Google Scholar 

  28. Moore RD, Smith WG (1999) Laparoscopic management of adnexal masses in pregnant women. J Reprod Med 44:97–100

    PubMed  CAS  Google Scholar 

  29. Yuen PM, Ng PS, Leung PL et al (2004) Outcome in laparoscopic management of persistent adnexal mass during the second trimester of pregnancy. Surg Endosc 18:1354–1357

    Article  PubMed  CAS  Google Scholar 

  30. Machado F, Vegas C, Leon J et al (2007) Ovarian cancer during pregnancy: analysis of 15 cases. Gynecol Oncol 105:446–450

    Article  PubMed  Google Scholar 

  31. Dgani R, Shoham Z, Atar E et al (1989) Ovarian carcinoma during pregnancy: a study of 23 cases in Israel between the years 1960 and 1984. Gynecol Oncol 33:326–331

    Article  PubMed  CAS  Google Scholar 

  32. Dudkiewicz J, Kowalski T, Grzonka D et al (2002) Ovarian tumors in pregnancy. Ginekol Pol 73:342–345

    PubMed  Google Scholar 

  33. ACOG Committee on Obstetric Practice (2011) ACOG Committee Opinion No. 474: nonobstetric surgery during pregnancy. Obstet Gynecol 117:420–421

    Article  Google Scholar 

  34. Pityński K, Basta A, Szczudrawa A et al (2002) Ovarian tumors in pregnancy in the material of the Department of Gynecology and Oncology Collegium Medicum of Jagiellonian University in Cracow. Ginekol Pol 73:371–375

    PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported by the Women’s Cancer Research Foundation.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Gynecologic Oncology Associates, 351 Hospital Road, Suite 507, Newport Beach, CA, 92663, USA

    Alberto A. Mendivil, John V. Brown III, Lisa N. Abaid, Mark A. Rettenmaier, John P. Micha & Bram H. Goldstein

  2. Women’s Cancer Research Foundation, Newport Beach, CA, 92663, USA

    Marie A. Wabe

Authors
  1. Alberto A. Mendivil
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. John V. Brown III
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lisa N. Abaid
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mark A. Rettenmaier
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. John P. Micha
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Marie A. Wabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Bram H. Goldstein
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Bram H. Goldstein.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mendivil, A.A., Brown, J.V., Abaid, L.N. et al. Robotic-assisted surgery for the treatment of pelvic masses in pregnant patients: a series of four cases and literature review. J Robotic Surg 7, 333–337 (2013). https://doi.org/10.1007/s11701-013-0394-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11701-013-0394-3

Keywords

Search

Navigation