Advanced Laparoscopy surgery
Laparoscopic surgery is often referred to as minimally invasive surgery. Laparoscopy utilizes small (1/2 inch or smaller) incisions instead of the large incision used in traditional open surgical procedures.
Initially, laparoscopy for pregnancy was felt to be more dangerous and, in fact, was contradicted. But with increases of technological advancement and surgical skills the opinions are changed.
The experience of surgeons and gynecologists is gaining more year after year; this led to use this procedure even during pregnancy for different intra-abdominal disorders. But the fetal and maternal wellbeing require special consideration.
The most frequent intra-abdominal disorders encountered during pregnancy are:
- acute appendicitis,
- gallbladder diseases,
- bowel obstruction and perforation,
- persistent ovarian cysts,
- twisted adnexal masses and
- other pathologies [2,3,4]
- maternal abdominal disorders
And its laparoscopic operative management is associated with fetal loss rate 2-24% according to the recent literature.
Laparoscopic surgery can be safely conducted in pregnant patients. And in any trimester. Pregnancy should no longer be considered a contraindication to laparoscopic surgery. The limiting factor of prime importance is an awareness of one’s own capabilities and limitations. The surgeon must be skilled in advanced laparoscopic techniques. And also in surgical obstetrics. A rural hospital setting is suitable for this type of procedure if there is a strong support structure in place to deal with potential complications.
The major advantages of laparoscopic surgery during pregnancy, over traditional laparotomy, are more or less the same as in a non-pregnant woman. These include smaller abdominal incisions resulting in less post-operative pain. It also leads to less infection and a reduced incidence of incisional hernias.
Further benefits of minimally invasive laparoscopic surgery are
- Early return of gastrointestinal activity (due to less manipulation of the bowel during surgery)
- Minimal post-operative adhesions and fewer incidences of intestinal obstruction.
- Shorter hospitalization time and prompt return to regular life
- Reduced risk of fetal depression by narcotic use