A 10‐year experience of laparoscopic surgery for adnexal masses during pregnancy

Koo, Yu-Jin; Lee, Jieun; Lim, Kyung-Taek; Shim, Jaewoo; Mok, Jung Eun; Kim, Tae-Jin

doi:10.1016/j.ijgo.2010.10.020

Cited by 28 publications

(39 citation statements)

References 9 publications

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“…Laparoscopy in pregnancy, especially in later pregnancy, is technically difficult owing to the increased risk of perforation and bleeding. Postoperatively, there is an increased risk of miscarriage or preterm delivery [21].…”

Section: Discussionmentioning

confidence: 99%

Management of adnexal torsion by laparoscopic approach

et al. 2012

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The study aimed to evaluate the effectiveness and safety of laparoscopic management of adnexal torsion. Early minimal invasive surgical management of adnexal torsion with the main emphasis on an organ-preserving procedure can safely be recommended. Although the incidence of adnexal torsions has increased, the morbidity rate has declined due to safer diagnostics and operative strategies. This is a retrospective case-control study (Canadian Task Force classification II-3) of 33 cases of adnexal torsion over an 11-year period (December 1999-September 2010) in a gynecologic endoscopy unit of a university hospital. Interventions include early diagnostic laparoscopy and utmost protection of the surrounding tissue. Thirty-three cases of laparoscopically managed adnexal torsions were analyzed. Fifty-two percent had conservative organ-sparing procedures, while 48 % underwent resection of ovary, tube, or both. The mean operating time was 69.2 min. There were no complications or conversions to laparotomy. The most common predisposing factor was an adnexal mass with symptoms of pain. Torsion on the right tube is more common than on the left. Laparoscopic surgery is an effective, safe, and feasible method in the diagnosis and treatment of adnexal torsion.

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Section: Discussionmentioning

confidence: 99%

Management of adnexal torsion by laparoscopic approach

et al. 2012

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“…2 Adnexal torsion is the most common complication of an adnexal mass occurring during pregnancy, and typically occurs in the first and second trimesters. 64, 66 Pregnant women are also at increased risk for recurrent adnexal torsion, either during the same pregnancy or subsequent pregnancies. 64 Compared to non-pregnant women with adnexal torsion, pregnant women with adnexal torsion are more likely to exhibit gastrointestinal symptoms and peritoneal signs on physical examination.…”

Section: Gynecological Causes Of Pelvic/abdominal Pain In the Non-prementioning

confidence: 99%

Unexpected Gynecologic Findings During Abdominal Surgery

Boyd

Riall

2012

Current Problems in Surgery

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“…Most studies published regarding management of adnexal masses during gestation encourage the use of open or Hasson technique [19,20,22,24], speculating that there is a higher risk of injury to the gravid uterus using the Veress needle method. Some studies have been published using the closed entry (Veress) technique [15,16,25], although there are no trials comparing the two in pregnant patients.…”

Section: Discussionmentioning

confidence: 99%

Closed entry technique for the laparoscopic management of adnexal mass during pregnancy

et al. 2014

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Management of adnexal masses during pregnancy is challenging for most gynecologists. When surgery is needed, a minimally invasive approach should be preferred. The aim of this study was to evaluate the safety and feasibility of the closed entry technique for laparoscopic management of adnexal masses during pregnancy. We reviewed clinical records and videos of laparoscopic procedures performed during pregnancy. Seventeen pregnant patients with diagnosis of adnexal mass that required surgery underwent laparoscopic surgery using the closed entry or Veress technique. We searched for complications related to surgery and obstetrical and perinatal outcomes. Median gestational age at the moment of surgery was 17 weeks (range, 6-30 +4 weeks). A total of 18 interventions were performed: 12 salpingo-oophorectomies, 3 cystectomies, 1 salpingectomy, and 2 ovarian detorsions. There were no major operative or entry-related complications. Median hospital stay was 2 days (range, 1-5). Perinatal outcomes were as follows: four preterm births (all of them induced), nine full-term deliveries, one early pregnancy loss at 7 weeks, one miscarriage at 18 weeks, and two ongoing uncomplicated pregnancies. Laparoscopic approach using closed entry technique with an individual selection of the puncture site is safe in the management of adnexal masses that require surgery during pregnancy. In our experience, the Veress technique is more versatile as it gives the surgeon more freedom to choose the location of the first trocar in patients with important space limitations due to the size of the adnexal mass and/or the enlarged gravid uterus.

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A 10‐year experience of laparoscopic surgery for adnexal masses during pregnancy

Abstract: Laparoscopic surgery for adnexal masses during pregnancy provided tolerable outcomes for the fetus and the mother. In the future, larger prospective clinical trials are necessary to elucidate fully the impact on the fetus.

Cited by 28 publications

References 9 publications

Management of adnexal torsion by laparoscopic approach

Management of adnexal torsion by laparoscopic approach

Unexpected Gynecologic Findings During Abdominal Surgery

Closed entry technique for the laparoscopic management of adnexal mass during pregnancy

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