Laparoscopic appendectomy in pregnancy is a critical clinical choice for surgeons managing the most common non-obstetric surgical emergency during gestation. While diagnostic challenges often arise as the pregnancy progresses, choosing the most effective surgical approach ensures better maternal and fetal outcomes. This single-center retrospective study evaluated the differences between laparoscopic and open surgery to guide evidence-based decisions for Indian healthcare providers.

Benefits of Laparoscopic Appendectomy in Pregnancy

The research highlights that the laparoscopic approach offers significant advantages in terms of operative efficiency. For instance, the laparoscopic group experienced a significantly shorter median operative time of 47 minutes compared to 58 minutes for the open surgery group. Additionally, both techniques showed similar rates of maternal postoperative complications, length of stay, and preterm births. Consequently, these findings support the use of laparoscopy as a safe and feasible option throughout various trimesters when expertise is available.

Furthermore, the study observed that diagnostic complexity increases significantly during late gestation. Specifically, the negative appendectomy rate rose to 28.6% in the third trimester. This trend underscores the importance of a meticulous diagnostic workup as the enlarging uterus alters typical clinical presentations and displaces the appendix. Therefore, multidisciplinary cooperation between surgeons, radiologists, and obstetricians remains essential for optimizing maternal care and avoiding unnecessary interventions.

FAQs

Is laparoscopic surgery safe in the third trimester?

Yes, while the third trimester presents higher diagnostic difficulty and increased negative appendectomy rates, laparoscopic surgery remains a safe option. Current guidelines suggest adjusting port placement to accommodate the enlarged uterus and recommend performance by experienced laparoscopic surgeons.

How does laparoscopy compare to open surgery for recovery?

Research indicates that laparoscopic surgery often results in shorter operative times and comparable lengths of hospital stay. Moreover, it is generally associated with less postoperative pain and lower wound infection rates, although maternal and obstetric safety remains high for both approaches.

Disclaimer: This content is for informational and educational purposes only. It does not constitute medical advice. Always consult a qualified healthcare professional for diagnosis and treatment. Refer to the latest local and national guidelines for clinical practice.

References

1. Bekraki A et al. Surgical outcomes of laparoscopic and open appendectomy in pregnant patients: A single-center retrospective cohort study. Turk J Surg. 2026 Feb 17. doi: 10.47717/turkjsurg.2026.2025-9-33. PMID: 41700467.


2. Rountis A et al. Laparoscopic appendectomy vs open appendectomy during pregnancy: a systematic review. Hippokratia. 2022;26(1):1-6.


3. Kumar SS et al. SAGES guidelines for the use of laparoscopy during pregnancy. Surg Endosc. 2024. doi: 10.1007/s00464-024-10672-1.