Background: Laparoscopic appendectomy (LA) is a safe, effective, and beneficial procedure for the
treatment of acute appendicitis. However, limited data are available regarding the safety and feasibility
of LA during pregnancy.
Methods: Between January 2001 and August 2004, 1235 patients with clinically suspected appendicitis
underwent laparoscopic surgery at our hospital. Eleven patients (0.9%) were pregnant
women (mean age, 25 years; age range, 19–37 years; range of gestational age, 4–30 weeks). Clinical
data collected retrospectively included demographic information; preoperative, procedural, and
postoperative information; and outcome of the pregnancy.
Results: All 11 pregnant women underwent laparoscopic surgery without need of conversion. Ten
patients underwent LA and were found to have acute appendicitis on histologic analysis. One patient
had torsion of the right fallopian tube and a healthy-looking appendix; she underwent detorsion
of the fallopian tube and incidental appendectomy. Mean operative time was 50.5 minutes
(range, 20–135 minutes). Length of postoperative hospital stay averaged 4.2 days (range, 1–11 days).
One patient had a surgical wound infection, which was managed conservatively. Mean follow-up
period was 14 months (range, 2–46 months). Seven pregnant women delivered healthy term infants,
2 had planned abortions, and 1 experienced fetal loss due to uterine infection and premature contractions
1 month after LA. Another patient had normal results at prenatal examination.
Conclusion: Our data support the accumulating evidence that LA is a safe and feasible procedure
for the treatment of acute appendicitis in all trimesters of pregnancy. Close maternal and fetal monitoring
is essential during and after the operation.
