Robotic Resection of Adnexal Masses during Pregnancy

Eichelberger, Kacey Y.; Cantrell, Leigh A.; Balthazar, Ursula; Boggess, Kim; Strauss, Robert A.; Boggess, John F.

doi:10.1055/s-0032-1324705

Cited by 6 publications

(4 citation statements)

References 14 publications

(15 reference statements)

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“…Several aspects of surgical planning are important to consider, and these include surgical approach (laparoscopy versus laparotomy), patient positioning to optimize patient hemodynamics, entry approach and location, use of carbon dioxide gas for peritoneal insufflation, uterine and adnexal manipulation, and choice of anesthesia. Although some studies have reported the use of robotic surgery for adnexal masses in pregnancy [19], no significant advantage over laparoscopy has been demonstrated. As previously mentioned, historically the preferred surgical approach is by laparotomy.…”

Section: Discussionmentioning

confidence: 99%

Surgical Management of Adnexal Masses in Pregnancy: A Systematic Review and Meta-analysis

Cagino¹,

Xuan²,

Thomas³

et al. 2021

Journal of Minimally Invasive Gynecology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Discussionmentioning

confidence: 99%

Surgical Management of Adnexal Masses in Pregnancy: A Systematic Review and Meta-analysis

Cagino¹,

Xuan²,

Thomas³

et al. 2021

Journal of Minimally Invasive Gynecology

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“…Eichelberger et al further compared the surgical and obstetric outcomes for robotic surgery with laparoscopic dissection of adnexal masses during pregnancy; the robotic surgery showed a significantly shorter length of hospital stay and blood loss [14]. However, cases of complete surgical staging procedure performed during pregnancy had not been illustrated.…”

Section: Discussionmentioning

confidence: 99%

Management of Ovarian Cancer in 14th Gestational Week of Pregnancy by Robotic Approach with Preservation of the Fetus

Chen

Chiu

Chan

et al. 2015

Gynecol Obstet Invest

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The objective of this study is to present a rare case of pregnancy complicated with ovarian cancer managed by robotic surgery. A 36-year-old woman suffered from sudden onset of lower abdominal pain during her pregnancy at 14 weeks of gestation. As malignancy was highly suspected, left salpingo-oophorectomy, bilateral pelvic lymph node dissection, and omentectomy were performed by robotic approach. The uterus and fetus were preserved. After surgery, 5 courses of carboplatin and paclitaxel were given, and the patient was delivered by cesarean section at 37 weeks of pregnancy. Follow-up at 18 months showed no signs of cancer recurrence. As there is limited report of pregnancy complicated with ovarian cancer managed by robotic surgery, we provide this rare case and suggest that surgical staging for ovarian malignancy can be safely accomplished by robotic approach at 14 weeks of pregnancy.

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“…There were no differences in operative time, intraoperative or postoperative complications, or obstetrical outcomes. 106 While there are limited data on robotic surgery in pregnancy, it appears to be both safe and feasible with comparable surgical and obstetrical outcomes.…”

Section: Surgical Approachmentioning

confidence: 99%

“…Eichelberger et al 106 examined the safety and feasibility of robotic-assisted resection of adnexal masses and compared surgical and obstetric outcomes of robotic versus laparoscopic removal. Patients who underwent robotic resection had a significantly shorter hospital stay and decreased blood loss.…”

Section: Surgical Approachmentioning

confidence: 99%

Adnexal Masses in Pregnancy

Dotters‐Katz

Kuller

et al. 2021

Obstetrical &Amp; Gynecological Survey

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Importance: Adnexal masses are identified in approximately 0.05% to 2.4% of pregnancies, and more recent data note a higher incidence due to widespread use of antenatal ultrasound. Whereas most adnexal masses are benign, approximately 1% to 6% are malignant. Proper diagnosis and management of adnexal masses in pregnancy are an important skill for obstetricians.Objective: The aim of this study was to review imaging modalities for evaluating adnexal masses in pregnancy and imaging characteristics that differentiate benign and malignant masses, examine various types of adnexal masses, and understand complications of and explore management options for adnexal masses in pregnancy.Evidence Acquisition: This was a literature review using primarily PubMed and Google Scholar.Results: Ultrasound can distinguish between simple-appearing benign ovarian cysts and masses with more complex features that can be associated with malignancy. Radiologic information can help guide physicians toward recommending conservative management with observation or surgical removal during pregnancy to facilitate diagnosis and treatment. The risks of expectant management of an adnexal mass during pregnancy include rupture, torsion, need for emergent surgery, labor obstruction, and progression of malignancy. Historically, surgical removal was performed more routinely to avoid such complications in pregnancy; however, increasing knowledge has directed management toward conservative measures for benign masses. Surgical removal of adnexal masses is increasingly performed via minimally invasive techniques including laparoscopy and robotic surgery due to a decreased risk of surgical complications compared with laparotomy.Conclusions and Relevance: Adnexal masses are increasingly identified in pregnancy because of the use of antenatal ultrasound. Clear and specific guidelines exist to help differentiate between benign and malignant masses. This is important for management as benign masses can usually be conservatively managed, whereas malignant masses require excision for diagnosis and treatment. A multidisciplinary approach, including referral to gynecologic oncology, should be used for masses with complex features associated with malignancy. Proper diagnosis and management of adnexal masses in pregnancy are an important skill for obstetricians.Target Audience: Obstetricians and gynecologists, family physicians Learning Objectives: After completing this activity, learners should be better able to compare different types of adnexal masses found in pregnancy, including incidence, clinical features, and imaging characteristics; evaluate an adnexal mass with imaging and laboratory tests; describe complications related to an adnexal mass in pregnancy; and determine management and/or surgical approaches for removal.

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Robotic Resection of Adnexal Masses during Pregnancy

Abstract: Robotic resection of adnexal masses during pregnancy appears both safe and feasible, with similar surgical outcomes when compared with a historic laparoscopic cohort.

Cited by 6 publications

References 14 publications

Surgical Management of Adnexal Masses in Pregnancy: A Systematic Review and Meta-analysis

Surgical Management of Adnexal Masses in Pregnancy: A Systematic Review and Meta-analysis

Management of Ovarian Cancer in 14th Gestational Week of Pregnancy by Robotic Approach with Preservation of the Fetus

Adnexal Masses in Pregnancy

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