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

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Abstract Management of adnexal masses during pregnancy is challenging for most gynecologists. When surgery is need-ed, 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 re-cords 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 themoment 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 nomajor operative or entry-related complications. Median hospital stay was 2 days (range, 1–5). Perinatal out-comes were as follows: four preterm births (all of them in-duced), 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 surgeonmore 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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Judul Seri

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No. Panggil

Artikel

Penerbit

USA : Springer., 2014

Deskripsi Fisik

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Bahasa

English

ISBN/ISSN

DOI 10.1007/s10397-0

Klasifikasi

NONE

Tipe Isi

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Tipe Media

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Tipe Pembawa

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Edisi

Gynecol Surg (2014) 11:213–218

Subjek

Medicine
pregnancy
laparoscopic

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Pernyataan Tanggungjawab

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