Laparoscopic appendectomy during the third trimester: Case presentation and literature review

Area of Science:

• General Surgery
• Obstetrics & Gynecology

Background:

• Acute appendicitis is a common surgical emergency during pregnancy.
• Laparoscopic appendectomy (LA) is the preferred minimally invasive treatment for appendicitis.
• LA in the third trimester poses challenges like technical difficulty and risks of preterm delivery.

Observation:

• Three successful cases of third-trimester LA were managed between 2011 and 2016 without conversion or complications.
• A literature review of 17 cases (2007-2016) showed a 11.8% conversion rate and 20% preterm delivery rate.
• No fetal loss was reported in the reviewed literature or the current case series.

Findings:

• Laparoscopic appendectomy can be performed safely in the third trimester of pregnancy.
• The procedure had a low complication rate and no fetal loss in the observed cases.
• Minimally invasive surgery is a viable option for appendicitis in late pregnancy.

Implications:

• LA may be a feasible and safe treatment for acute appendicitis during the third trimester.
• This approach can potentially reduce maternal and fetal risks associated with open surgery.
• Further research can validate LA as a standard of care in advanced pregnancy.