The History of Non-obstetric Endoscopic Surgery During Pregnancy

Abstract

The development of non-obstetric endoscopic surgery in pregnancy is relatively recent. Studies investigating the use of anesthesia and the performance of non-obstetric surgery in pregnancy were not performed until the second half of the twentieth century. Around the same time, video-assisted laparoscopy was invented and pioneered by Camran Nezhat, and as it became embraced by the surgical community, it was also applied to the pregnant patient. Early concerns about the use of laparoscopy in pregnancy revolved around the unknown effects of anesthesia and pneumoperitoneum on the fetus, difficult surgical entry due to the enlarged uterus with a potential for uterine injury, and the physiologic changes inherent to pregnancy. Numerous studies have demonstrated the safety of anesthesia in pregnancy, and pneumoperitoneum has likewise been shown to be safe for the mother and fetus. Once the feasibility of laparoscopic entry was demonstrated, a variety of procedures were demonstrated to be safe in pregnancy. Now, surgical procedures may be performed as indicated in any trimester of pregnancy.