Laparoscopic surgery in pregnancy. A case report with a brief review of the topic.

A 32-year-old white lady suffering from tubal infertility was referred to our institution in November 1992 because of low abdominal pain due to a heterotopic pregnancy (one intrauterine sac and the other in the right tube). The patient had undergone, 8 weeks before, her second successful attempt at in vitro fertilization and embryo transfer. We decided to perform a laparoscopic salpingectomy. At inspection, the presence of tubo-ovarian adhesions was noted, secondary to the previous tubal microsurgical procedure, that were lysed by means of monopolar electrocoagulation. Salpingectomy was performed by combined bipolar cauterization and blunt-scissor dissection of the mesosalpinx. No uterine contractions were noted after surgery and the patients were discharged the next day. The rest of the pregnancy was uneventful and the patient spontaneously delivered vaginally a healthy female newborn weighing 3,060 g (Apgar score = 9) on June 20, 1993, at 39 weeks of gestation. A review of the published literature on laparoscopic surgery in pregnancy is given.