Diagnosis and laparoscopic treatment of surgical diseases during pregnancy: an evidence-based review

Surg Endosc. 2008 Sep;22(9):1917-27. doi: 10.1007/s00464-008-9989-6. Epub 2008 Jun 14.


Treatment of surgical disease in the gravid patient requires a unique and careful approach where safety of the mother and fetus are both considered. Approaches to diagnosis and therapy of surgical disease in the gravid patient are increasingly clarified and defined in the literature. Laparoscopy, once described as contraindicated in pregnancy, has been steadily accepted and applied as data supporting its safety and use have accumulated. An extensive review of the literature was performed to define the use of laparoscopy in pregnancy. Diagnoses for independent surgical diseases as well as imaging modalities and techniques during pregnancy are reviewed. Preoperative, intraoperative, and postoperative management of the pregnant patient are described and evaluated with focus on use of laparoscopy. Literature supporting safety and efficacy of laparoscopy in cholecystectomy, appendectomy, solid organ resection, and oophorectomy in the gravid patient is outlined. Based on level of evidence, this review includes recommendations specific to surgical approach, trimester of pregnancy, patient positioning, port placement, insufflation pressure, monitoring, venous thromboembolic prophylaxis, obstetric consultation, and use of tocolytics in the pregnant patient.

Publication types

  • Review

MeSH terms

  • Abortion, Spontaneous / prevention & control
  • Capnography
  • Diagnostic Imaging / adverse effects
  • Diagnostic Imaging / methods
  • Emergencies
  • Evidence-Based Medicine
  • Female
  • Fetal Diseases / prevention & control
  • Fetus / radiation effects
  • Humans
  • Laparoscopy* / adverse effects
  • Laparoscopy* / methods
  • Minimally Invasive Surgical Procedures
  • Obstetric Labor, Premature / drug therapy
  • Obstetric Labor, Premature / prevention & control
  • Pneumoperitoneum, Artificial
  • Pregnancy
  • Pregnancy Complications / diagnosis
  • Pregnancy Complications / diagnostic imaging
  • Pregnancy Complications / surgery*
  • Pregnancy Complications, Hematologic / prevention & control
  • Radiography
  • Thromboembolism / prevention & control
  • Tocolytic Agents / administration & dosage
  • Tocolytic Agents / therapeutic use
  • Ultrasonography


  • Tocolytic Agents