A Woman in Late Pregnancy Operated on in Israel
The operation saved the woman's life and did not harm the fetus.
Usually, doctors try to postpone surgery until the woman gives birth. However, there are situations where delaying poses a threat to the life or health of the patient. A woman at 34 weeks of pregnancy underwent emergency surgery without harming the fetus and preserving the patient's health. The latest technique involves performing laparoscopic surgery on pregnant women without extensive incisions, in a gentle manner.
A pregnant woman experiencing severe abdominal pain approached an Israeli clinic. The patient was immediately taken for diagnostics, and it turned out that the problems were not with the condition of the fetus – the patient was found to have a dangerous pathology called "ovarian torsion." As a result of ovarian torsion, blood supply to the appendages is disrupted, which can lead to dangerous conditions, including gangrene. The woman required urgent surgical intervention, but performing a full abdominal surgery at such a late stage of pregnancy is impossible. Then Israeli doctors decided to perform laparoscopic surgery, which involves surgical intervention through small incisions of no more than 0.5 cm.
The laparoscopic method of performing surgeries has been increasingly used lately; it is a safe alternative to traditional invasive surgical interventions. This method allows for the avoidance of large incisions, significantly reducing the postoperative period and sparing the patient from scars and marks. In leading clinics in Israel, laparoscopic surgeries are also performed on pregnant women.
The patient with ovarian torsion underwent exactly such an operation. To access the area that needed to be operated on, the doctors used a trocar – an instrument that is a hollow narrow tube through which surgical instruments and an optical device are introduced. The trocar was fixed in the abdominal wall using a Hasson fixer, a special cone.
The surgeons needed half an hour to perform the operation. During this time, the medical team identified the damaged area, performed manipulations to resolve the issue and restore blood supply, and then the doctors sutured the puncture site. The patient's recovery period lasted two days, and then, at the appropriate time, the woman gave birth to a completely healthy baby.
Minimally Invasive Surgical Techniques for Pregnant Women
Minimally invasive surgical methods, even the most complex ones, have been practiced in Israel for a long time, and now gentle techniques are also used for surgical interventions on pregnant women. Endoscopic and laparoscopic surgeries require special skills, which is why the Israeli National Center for Medical Stimulation has an endoscopy training center where surgeons can acquire practical and theoretical skills that enable them to perform minimally invasive surgeries. Surgeons are trained to perform this type of surgery on pregnant women. The "interesting position" of the patient significantly complicates the surgeon's task, as the uterus of a pregnant woman is significantly larger, and additionally, the intestines are somewhat displaced under the pressure of the cervix. These factors complicate access to certain organs in the abdominal cavity, and performing surgery requires special mastery, knowledge, and skills.
No Need to Wait for Delivery
Planned surgeries for pregnant women are usually postponed until delivery and postpartum recovery. However, there are cases where postponing surgery is simply impossible, such as in the case of a patient with ovarian torsion. There are also several other situations where delaying surgical intervention cannot be done (internal bleeding into the abdominal cavity, appendicitis). If the patient is at the end of her pregnancy, the complexity of the surgical intervention increases manifold. Israeli surgeons expertly perform surgeries at late stages of pregnancy, preserving the patient's health and causing no harm to the fetus.
During laparoscopic surgery, to increase access to the operated area and facilitate the surgeon's work, carbon dioxide is pumped into the patient's abdominal cavity. After that, several small incisions or punctures are made through which instruments are introduced into the abdominal cavity. The surgeon carefully shifts the uterus with the fetus to the side to avoid disrupting blood supply. Throughout the operation, constant monitoring of the patient's vital functions is conducted: blood pressure, heart rate, and so on. After the operation, the patient is left with no scars, only a small mark that gradually dissolves over time.
Sometimes the laparoscopic method is also used for planned surgeries on pregnant women, usually when there are ovarian pathologies present. However, there are contraindications for performing surgical interventions, for example, it cannot be performed on women with a pregnancy term of less than 14 weeks. This is because intervention at early stages can harm the uterus and the fetus.
Safety of the Method
Before performing such interventions, studies were conducted in Israel that proved: the laparoscopic method of performing surgery is completely safe for the future child. Numerous studies have shown that this type of surgery does not pose a threat of premature birth and does not provoke the development of any fetal pathologies. And when compared to traditional surgeries, it has many advantages for pregnant women. One of them is a low percentage of blood loss, reduced risk of postoperative complications, and a quick recovery period.