Non-Obstetric Surgery During Pregnancy

  As minimally invasive surgical techniques evolve, the outlook for patients continues to brighten. This is also true for pregnant women experiencing conditions requiring surgical intervention during gestation. A physician’s ability to identify potential risk factors in pregnant patients that present pre-op directly corresponds with their success in monitoring patients in post-op for adverse obstetric outcomes from non-obstetric surgeries. The utilization of laparoscopic techniques during surgery for pregnant patients has decreased the risk of fetal complications and increased the positive outlook for the duration of the pregnancy. 

This text is designed to present a minimally invasive approach to surgery that is non-obstetrics related and to educate readers on the potential risk factors and negative outcomes on pregnant patients following non-obstetric surgery. The various sections of this book will address issues faced by surgeons who undertake the task of operating on the pregnant patient. When performing non-obstetric surgery on a pregnant patient the ability to identify possible risk factors for adverse obstetric outcomes is important. Risk factors can be maternal-, surgical-, obstetrical-, or disease-associated. Common adverse obstetric outcomes following non-obstetric surgery include preterm delivery, preterm labor without preterm delivery, and miscarriage. Fetal well-being is an additional risk-benefit factor to be considered when weighing options before conducting non-obstetric surgeries on pregnant patients. This book will provide physicians with the knowledge and tools to identify common risk factors and successfully apply evidence-based risk reduction. 

 To date, no comprehensive resource is available for non-obstetric surgery during pregnancy.  Types of pregnancies, potential complications, proper use of anesthesia, types of risk factors (maternal-, surgical-, obstetrical-, and disease-associated), etc. will be thoroughly explained and depicted within these pages.  All chapters will be written by subject matter experts in their fields.  All information communicated will be comprised of the most currently available knowledge

The History of Non-Obstetric Endoscopic Surgery during Pregnancy.- Neurological Pathway of Non-Obstetric Pain during Pregnancy.- Non-Obstetric Imaging in Pregnant Women.- Instrumentation for Non-Obstetric Surgery during Pregnancy.- Operating Room Set-Up and Patient Positioning for Non-Obstetric Surgery During Pregnancy.- The Pneumoperitoneum during Pregnancy.- Anesthetic Considerations for the Gravid Patient for Non-Obstetric Surgery.- Medical Complications in Pregnancy.- Trauma and Surgical Management During Pregnancy.- Acute Appendicitis during Pregnancy.- Cholelithiasis, Cholecystitis, and Cholecystectomy during Pregnancy.- Upper and Lower Endoscopy for Gastrointestinal (GI) Bleeding in Pregnancy.- Small Bowel Obstruction and Volvulus during Pregnancy.- Surgical Management of Inflammatory Bowel Disease in Pregnancy.- Colorectal Cancer in Pregnancy.- Hernia Complications during Pregnancy.- Breast Surgery in the Pregnant Patient.- Neurosurgery During Pregnancy.- Ophthalmology Surgery during Pregnancy.- Oral and Maxillofacial Surgery for the Pregnant Patient.- Urologic Surgery during Pregnancy.- Non-elective Orthopaedic Procedures and Circumstances in Pregnant Patients.- Myomas and Pregnancy.- Adnexal Mass in Pregnancy.- Ovarian Cancer in Pregnancy.- Ectopic and Heterotopic Pregnancies.- Molar Pregnancy.- Transabdominal Cervical Cerclage.- Congenital Uterine Anomalies in Pregnancy.- Uterine Incarceration During Pregnancy.- Spontaneous Uterine Rupture During Pregnancy.- In Utero Surgery for Spina Bifida Aperta.- Laser Treatment of Twin-Twin Transfusion Syndrome.

Michael S. Kavic, MD
Professor Emeritus of Surgery
Northeast Ohio Medical University
Editor-in-Chief, JSLS and CRSLS
1044 Belmont Ave
Youngstown, OH 44504, USA

Raymond J. Lanzafame, MD, MBA, FACS 
Research Associate Professor, State University of New York at Buffalo
School of Dental Medicine, State University of New York at Buffalo
Executive Director and Scientific Chair,
Society of Laparoendoscopic Surgeons 
757 Titus Avenue
Rochester, NY14617-3930, USA

Michael K. Lindsay MD, MPH
Associate Professor, Division of Gynecology & Obstetrics
Emory University School of Medicine
Director Division Maternal Fetal Medicine &
Chief of Service for Gynecology & Obstetrics
Grady Memorial Hospital, Atlanta Georgia
550 Peachtree St NE
Atlanta, GA 30308, USA