[Laparoscopic surgery and pregnancy]

Laparoscopic surgery during pregnancy is still under evaluation. Most of published papers include few patients. The literature review reveals that laparoscopic cholecystectomy is the most performed procedure, followed by appendectomy and adnexal surgery. Intra-operative measures (surgical and medical) to prevent complications, appear of paramount importance. Results of published series suggest that laparoscopy during pregnancy is feasible and safe for both mother and fetus. Nevertheless, all studies are retrospective and included few patients, therefore drawing a definitive conclusion is questionable. On the other hand, experimental studies suggested a deleterious effect of pneumoperitoneum on fetus (fetal acidosis). But clinical relevance of these experiments is controversial and their results are conflicting. It would be tempting to conclude that laparoscopic surgery is the "gold standard" during pregnancy but the lack of strong scientific evidence does not allow, at present, to conclude that this conclusion is evidence based. Prospective trials or registries are needed to confirm the encouraging preliminary results in the literature.