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Laparoscopic surgery for presumed benign ovarian tumor during pregnancy

Bunyavejchevin S, Phupong V
Published Online: 
31 January 2013

No randomized controlled trials to compare 'open surgery' with 'keyhole surgery' in pregnant women for non-malignant tumors of the ovary.

A small number of women have tumors of the ovaries diagnosed during pregnancy. Most of these tumors are not malignant, and if they are small then treatment can be left until after the birth. However, if the tumour is larger that 6 cm in diameter, it is suggested that it is better to operate and remove them during pregnancy, as they may interfere with the birth of the baby. Surgical procedures for these non-malignant tumors of the ovary in pregnancy can be performed by open surgery (laparotomy) or keyhole surgery (laparoscopy) techniques. Historically, open surgery has been used, but new keyhole surgery seems attractive in that it appears to require a shorter hospital stay and there is a quicker return to normal activities for women. However, the infusion of gas into the abdomen during the key-hole procedure may have adverse effects on the baby, and an additional gasless technique is also under study. This review aimed to address the question of which surgical technique might be better as all have benefits and risks to the mother and the baby. There were no randomized controlled trials identified that compared the effects of using keyhole surgery for benign tumors of the ovary during pregnancy on maternal and fetal health. There was some evidence available from case series studies, but more research is needed on the potential benefits and harms associated with this new surgical technique in pregnancy.