Laparoscopic appendicectomy in all trimesters of pregnancy

Background: The laparoscopic approach for appendicectomy in pregnancy was not considered the preferred procedure until recently. The aim of this study was to examine our experience with laparoscopic appendicectomy in pregnancy and review the scientific evidence available in the medical literature. Method: The clinical data of all patients who underwent laparoscopic appendicectomy during pregnancy at our hospital between 1999 and 2007 were collected and retrospectively analyzed. A Medline literature search restricted to English language articles on laparoscopic appendicectomy in pregnancy was carried out. Result: Twenty patients underwent laparoscopic appendicectomy during pregnancy. Of these, 8 were in the first trimester, 9 in the second trimester, and 3 in the third trimester. Fifteen patients had histologically confirmed appendicitis. The mean operating time was 45 minutes and the average postoperative stay in the hospital was 1.5 days. All patients except one had a full-term normal delivery. Literature search: An additional 637 patients from the English literature were reviewed and summarized. Conclusion: Our results demonstrate that laparoscopic appendicectomy can be safely performed during all trimesters of pregnancy. The literature search suggests that although laparoscopic appendicectomy in pregnancy is associated with a low rate of intraoperative complications in all trimesters it may be associated with a significantly higher rate of fetal loss compared with open appendicectomy.