Laparoscopic management of adnexal masses in pregnancy: a case series

Mathevet, Patrice; Nessah, Karima; Dargent, D; Méllier, G

doi:10.1016/s0301-2115(02)00374-3

Cited by 147 publications

(107 citation statements)

References 18 publications

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“…So far, no significant or clinically relevant differences have been found between any technique [19][20][21][22]. A meta-analysis published recently found no difference in major vascular or visceral complications.…”

Section: Discussionmentioning

confidence: 99%

“…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%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

et al. 2014

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“…Como desafío futuro está implementar la resolución de estas lesiones con laparoscopia ya que se ha demostrado no afectar los resultados perinatales, logrando menor tiempo de hospitalización y dolor post operatorio (10,11,12).…”

Section: Discussionunclassified

Tumores Anexiales Y Embarazo

Tapia

Orellana

Cisterna

et al. 2005

Rev. chil. obstet. ginecol.

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“…Malignant ovarian tumors and endometriomas are rarer causes due to adhesions or invasion of the neighboring tissues. Adnexal mass may be palpated on examination, but the diagnosis, the definition of its morphology and the stratification of risk may be made by means TVS and TAS [31][32][33].…”

Section: Adnexal Mass In Pregnancymentioning

confidence: 99%

Diagnosis of emergencies/urgencies in gynecology and during the first trimester of pregnancy

Zucchini¹,

Marra²

2014

J Ultrasound

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Several surgical and/or medical emergencies/ urgencies may occur in gynecologic patients and in pregnant women during the first trimester. Particularly, ectopic pregnancies, ruptured or hemorrhagic ovarian cysts, ovarian or adnexal torsions, threatened or inevitable miscarriages, phlogistic gynecological disorders, complications involving the uterine fibroids, endometriosis, and spontaneous uterine rupture are possible acute complications. The diagnosis is suspected on the basis of symptoms (acute pelvic and/or abdominal pain, with or without vaginal bleeding or discharge, until acute abdomen with peritonitis), by means physical evaluation (abdominal, pelvic, and bimanual gynecological examinations), by means of transabdominal (TAS) and/or transvaginal (TVS) sonography, and laboratory tests. However, the diagnosis is often not that simple, especially when the symptoms and clinical signs are minimal, and ultrasound (US) examination is not diriment. The differential diagnosis of abdominal/pelvic pain is broad and includes primarily gastrointestinal and urogenital disorders. Generally, TAS should usually be used in conjunction with TVS for evaluation of the female pelvis. If the US examination is not conclusive, CT or MRI, especially in pregnant patients, should be considered.Riassunto Diverse emergenze/urgenze chirurgiche e/o mediche possono interessare le pazienti ginecologiche e le gravide al primo trimestre. In particolare, le gravidanze ectopiche, le cisti ovariche rotte o torte, le torsioni ovariche o annessiali, le minacce d'aborto o gli aborti inevitabili, le patologie infiammatorie ginecologiche, i fibromi uterini complicati, l'endometriosi e la rottura uterina spontanea rappresentano possibili complicanze acute. La diagnosi può essere sospettata in base alla sintomatologia (algie pelviche e/o addominali acute, con eventuali perdite vaginali, fino a un quadro di addome acuto con peritonite), alla visita (valutazione addominale, pelvica ed esplorazione ginecologica bimanuale), all'ecografia transaddominale (TAS) e/o transvaginale (TVS), e agli esami di laboratorio. Tuttavia, la diagnosi spesso non è semplice, soprattutto quando i sintomi e i segni clinici sono lievi e l'ecografia non è dirimente. La diagnosi differenziale del dolore addominale/ pelvico comprende un'ampia varietà di disordini, in particolare gastrointestinali e urogenitali. Generalmente, la valutazione della pelvi femminile dovrebbe essere eseguita mediante ecografia sia transaddominale che transvaginale. Se l'esame ecografico non consente di fare diagnosi, dovrebbero essere presi in considerazione la TC o, specialmente nelle donne gravide, la RMI.

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Laparoscopic management of adnexal masses in pregnancy: a case series

Cited by 147 publications

References 18 publications

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

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

Tumores Anexiales Y Embarazo

Diagnosis of emergencies/urgencies in gynecology and during the first trimester of pregnancy

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