Use of Laparoscopy During Pregnancy

Publication Date: May 3, 2024
Last Updated: May 13, 2024

Summary of Recommendations

The panel suggests that appendectomy rather than nonoperative treatment should be used for acute appendicitis during pregnancy. (C, VL )
620
The panel suggests that laparoscopic appendectomy rather than open appendectomy should be used for acute appendicitis when the fundus of the uterus is below the umbilicus. (U, CC)
620
The panel suggests that laparoscopic or open appendectomy should be used for acute appendicitis when the fundus of the uterus is above the umbilicus, at the surgeon’s discretion. The panel additionally suggests the open establishment of pneumoperitoneum when the laparoscopic approach is utilized. (U, CC)
620
The panel suggests that laparoscopic cholecystectomy should be used rather than nonoperative treatment for the management of biliary disease during pregnancy. (C, VL )
620
For acute cholecystitis during pregnancy, the panel suggests laparoscopic cholecystectomy rather than nonoperative treatment. (C, L )
620
For biliary colic during the third trimester of pregnancy, the panel suggests either nonoperative treatment or laparoscopic cholecystectomy may be considered. (C, CC)
620
The panel suggests ERCP rather than common bile duct exploration for the treatment of symptomatic choledocholithiasis during pregnancy. (C, CC)
620
The panel suggests that
Indications for emergent surgical intervention should be the same in the pregnant and non-pregnant IBD patient (C, CC)
620
Pregnant patients requiring emergent surgical treatment of IBD, given the high maternal and fetal complication rates, should undergo an open surgical approach (C, CC)
620
Pregnant patients with active IBD flares should be managed in a multidisciplinary fashion at centers with IBD expertise (C, CC)
620

Recommendation Grading

Disclaimer

The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.

Overview

Title

Use of Laparoscopy During Pregnancy

Authoring Organization

Society of American Gastrointestinal and Endoscopic Surgeons

Publication Month/Year

May 3, 2024

Last Updated Month/Year

August 7, 2024

Document Type

Guideline

Country of Publication

US

Document Objectives

When pregnant patients present with nonobstetric pathology, the physicians caring for them may be uncertain about the optimal management strategy. The aim of this guideline is to develop evidence-based recommendations for pregnant patients presenting with common surgical pathologies including appendicitis, biliary disease, and inflammatory bowel disease (IBD).

Inclusion Criteria

Female, Adult

Health Care Settings

Ambulatory, Outpatient, Operating and recovery room

Intended Users

Nurse, nurse practitioner, physician, physician assistant

Scope

Management

Diseases/Conditions (MeSH)

D011247 - Pregnancy, D010535 - Laparoscopy

Keywords

pregnancy, laparoscopy

Source Citation

Kumar SS, Collings AT, Wunker C, Athanasiadis DI, DeLong CG, Hong JS, Ansari MT, Abou-Setta A, Oliver E, Berghella V, Alli V, Hassan I, Hollands C, Sylla P, Slater BJ, Palazzo F. SAGES guidelines for the use of laparoscopy during pregnancy. Surg Endosc. 2024 May 3. doi: 10.1007/s00464-024-10810-1. Epub ahead of print. PMID: 38700549.