Laparoscopy in Pregnancy and the Pediatric Patient

Gynecologic laparoscopy has gained momentum in the past 2 decades. It is considered the standard of care in the treatment of certain pathology in the pediatric and adolescent populations such as endometriosis, ovarian cystectomy, ovarian torsion, and ovarian transpostion. The application of laparoscopy in pregnancy, however, has been slow to gain widespread acceptance. Physiologic and anatomic changes in the pregnant patient introduce certain risks unique to this population. Although pregnancy is considered a relative contraindication for laparoscopic procedures, data indicate that these concerns may be unwarranted when procedures are performed by skilled surgeons. Appendicitis, cholecystitis, ovarian torsion, and symptomatic adnexal masses are some of the more common conditions necessitating intervention. Although prospective studies of laparoscopic surgery in pregnancy are lacking, there are numerous case reports affirming the feasibility of this approach.