Safety and Feasibility of a Single-port Laparoscopic Adnexal Surgery During Pregnancy

Study Objective: To evaluate the safety and feasibility of single-port laparoscopic adnexal surgery during pregnancy. Design: A retrospective study (Canadian Task Force Classification III). Setting: A university hospital. Patients: A total of 14 women with intrauterine pregnancy who underwent single-port laparoscopic surgery (SPLS). Intervention: We retrospectively reviewed the medical records of 14 women with intrauterine pregnancy who underwent SPLS between November 2009 and September 2012 for the treatment of an adnexal mass. Measurements and Main Results: Factors investigated included the duration of surgery, differences between preoperative and postoperative hemoglobin, the size of the mass as measured by ultrasonography, major intraoperative or postoperative complications, conversion to multiport laparoscopy, and pregnancy outcomes. Single-port laparoscopic adnexal surgery was successfully performed in all 14 pregnant patients with an adnexal mass. The median gestational age at operation was 9 weeks (range, 4 weeks-17 weeks 4 days). Procedures included ovarian cystectomy with or without detorsion (n = 9), cyst aspiration with detorsion (n = 2), salpingectomy (n = 2), and salpingostomy (n = 1). The median duration of surgery was 59 minutes (range, 36-84 minutes). No major intraoperative or postoperative complications were encountered, and there was no need for conversion to multiport laparoscopic surgery. Five women had spontaneous vaginal delivery, and 5 women underwent cesarean delivery at term. One woman had preterm delivery at a gestational age of 24 weeks 5 days. In 1 case, abortion occurred 2 weeks after the operation. Conclusion: Based on these initial findings, SPLS appears to be a safe and technically feasible treatment for an adnexal mass during pregnancy. (C) 2013 AAGL. All rights reserved.