Background. Surgical treatment during pregnancy has double responsibility about safety of pregnant woman and fetus. Miniinvasive technologies increase efficacy of surgery for various diseases but pregnancy was an absolute contraindication for using laparoscopy. Regardless possible threat development of fetus hypoxia, pneumoamnion, negative influence of pneumoperitoneum for pregnant, results of introduction videosurgical technologies confirmed possibility of using laparoscopy during pregnancy with following technical conditions.
Aim is research of technical conditions for increasing safety and efficacy of laparoscopic appendectomy during pregnancy and evaluation condition of uterus and fetus in early postoperative period.
Materials and methods. There were examined 75 pregnant women with acute appendicitis who undergone laparoscopic surgery. Analysing results of antenatal cardiotocography before and after surgery in gestation from 28 weeks.
Results and discussion. In our research there worked out trocar placements depending on trimesters. During I and II trimester there was used method of closed laparoscopy and 1st trocar inserted paraumbilical. 2nd 5 mm trocar’s position was in left lower quadrant or in mesogastrium; 3rd 10 mm — in projection of appendix. During the end of II and III trimester we used open Hasson technique. Trocar placements depended on uterus fundal height. 2nd and 3rd ones inserted under clear visual control of it into abdominal cavity.
Conclusion. Scheme of choice trocar placements and method of instrumental insertion depending on gestation age were safe and acceptable. Conditions of realization endovideosurgery have no adverse outcomes for woman and her fetus.