Laparoscopy in Pregnant Patients
The need for abdominal surgery in the pregnant patient is not uncommon. The indication for non-obstetrical surgery during pregnancy should be approached in a similar fashion to the nonpregnant patient. While laparotomy has traditionally been used to address surgical disorders of the peritoneal cavity, the use of laparoscopy is a safe approach with many advantages and should be utilized, when appropriate. An understanding of the physiologic changes that occur during pregnancy is important to the operating surgeon, and anatomic alterations within the abdominal cavity will affect port placement. Proper patient positioning and fetal monitoring are also important in helping to prevent fetal loss during surgery. This chapter will discuss the use of laparoscopy in the pregnant patient with surgical disorders affecting the colon and rectum.
KeywordsAcute Appendicitis Pregnant Patient Fetal Loss Acute Diverticulitis Toxic Megacolon
Near obstructing colon cancer in a pregnant patient. This patient underwent an open anterior resection with end colostomy. The video demonstrates some of the potential difficulties encountered in the pregnant patient. Video by Amir Bastawrous, MD (MP4 95188 kb)
- 8.Guyton AC, Hall JE. Guyton and Hall textbook of medical physiology. 11th ed. Philadelphia: Saunders; 2005.Google Scholar
- 12.American College of Obstetricians Gynecologists. ACOG Committee opinion no. 548: weight gain during pregnancy. Obstet Gynecol. 2013;121(1):210–2.Google Scholar
- 20.Squires RA. Surgical considerations in pregnancy. Audio Dig Gen Surg. 1998;45:6.Google Scholar