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Pneumoperitoneum for Laparoscopic Surgery During Pregnancy

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Abstract

Creating a pneumoperitoneum for laparoscopic surgery is safe during pregnancy. However, attention to detail is paramount because the margins of error are smaller and the physiology more temperamental than for a nonpregnant patient. Furthermore, two persons—mother and fetus—are involved in the surgical event. The gas should be preconditioned by humidifying and warming to physiologic conditions to reduce hypothermia, decrease peritoneal damage, and improve outcomes. There should be continuous end-tidal CO2 monitoring. The patient should be in the left lateral decubitus position. Intra-abdominal pressure should not exceed 15 mmHg, but should be less if abdominal compliance warrants; the procedure can be performed safely at lower pressure without compromising the outcome. Venous thrombosis prevention should be performed using intraoperative and postoperative compression devices with early ambulation. Perioperative fetal monitoring should be done when there is a viable fetus. Tocolytic prophylaxis may be required perioperatively if there are signs of preterm labor.

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Authors and Affiliations

  1. Biomedical Engineering, Mercer University, Macon, GA, USA

    Douglas E. Ott

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  1. Douglas E. Ott
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Editors and Affiliations

  1. Nezhat Medical Center, Atlanta, GA, USA

    Ceana H. Nezhat

  2. Department of Surgery, Northeast Ohio Medical University, Youngstown, OH, USA

    Michael S. Kavic

  3. School of Dental Medicine, State University of New York at Buffalo, Buffalo, NY, USA

    Raymond J. Lanzafame

  4. Department of Gynecology and Obstetrics, Emory University, Atlanta, GA, USA

    Michael K. Lindsay

  5. Division of Trauma and Surgical Critical Care, LAC+USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    Travis M. Polk

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Ott, D.E. (2019). Pneumoperitoneum for Laparoscopic Surgery During Pregnancy. In: Nezhat, C., Kavic, M., Lanzafame, R., Lindsay, M., Polk, T. (eds) Non-Obstetric Surgery During Pregnancy. Springer, Cham. https://doi.org/10.1007/978-3-319-90752-9_6

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