Single Incision Laparoscopic Surgery in Pregnancy: a Case Report and Review of the Literature

Laparoendoscopic single-site surgery (LESS), also known as single incision laparoscopic surgery (SILS), is advancing the minimally invasive surgical approach and used as surgical technique in gynecologic surgery. Herein, we describe our experience with a case report utilizing the SILS in pregnancy and discussing relevant peer-reviewed English literature. A 42-year old female, who was pregnant at 17-week gestational age, presented with sudden onset right lower abdominal pain. Her lab results were: white blood count (WBC) 13,000, and hemoglobin (Hb) 106 g/L. Pelvic ultrasound characteristic revealed right large adnexal cyst measuring 12x12x7 cm with torsion. Diagnosis of ovarian cyst with torsion was made, which indicated surgical intervention during pregnancy. SILS was performed using single-port through 2 cm umbilical incision to the peritoneal cavity. Uterus and left ovary with adnexa were normal. Right ovarian cyst with torsion was identified. Un-twisting of the torted pedicle and ovarian cystectomy was performed, the patient had a spontaneous vaginal delivery at 38-weeks. Thus, we report our successful experience of SILS in pregnancy without any complications. This report is one of the early experiences using SILS in pregnancy without any complications, and likely be the first from the Arab World (Middle-East) experience. This case highlights the possibility of considering SILS option for intervention in gynecologic surgeries during pregnancy. Further studies would be desirable to determine short- and long-term outcomes.