TY - JOUR
T1 - Emergent Laparoscopic Removal of a Perforating Intrauterine Device During Pregnancy Under Regional Anesthesia
AU - Giampaolino, Pierluigi
AU - Della Corte, Luigi
AU - Di Spiezio Sardo, Attilio
AU - Zizolfi, Brunella
AU - Manzi, Alfonso
AU - De Angelis, Carlo
AU - Bifulco, Giuseppe
AU - Carugno, Josè
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Study Objectives: To describe and demonstrate a technique for laparoscopic removal of a perforating intrauterine device (IUD) during pregnancy, and to provide tips to facilitate safe laparoscopic surgery during pregnancy. Design: Video presentation of the technique for laparoscopic removal of a perforating IUD in a pregnant woman. Setting: Department of Neuroscience, Reproductive Sciences, and Dentistry, University of Naples Federico II, Naples, Italy. Intervention: A 30-year-old woman, gravida 3, para 2, with a copper T IUD (Nova T 380; Bayer, Leverkusen, Germany) perforating the left adnexa presented to the emergency room complaining of left lower quadrant pain. The patient had the IUD inserted by her gynecologist 3 months before the onset of the symptoms. Ultrasound revealed a 6-week intrauterine pregnancy with the presence of fetal cardiac activity along with the IUD perforating the left adnexa. The patient returned at 11 weeks of gestation complaining of worsening abdominal pain and excruciating left lower quadrant pain. She was scheduled for laparoscopic excision of the perforating IUD [1-3]. Considering her pregnancy, laparoscopy under regional anesthesia was performed in the minimal Trendelenburg position at 12 degrees, through open laparoscopic access [4]. Intra-abdominal pressure of 8 mmHg and ultrasound energy to cut and coagulate, avoiding monopolar/bipolar energy owing to the presence of a copper IUD, were used. The IUD and tube were extracted in an endobag through umbilical access, under a 5-mm, 0-degree telescope in left lateral access [5]. The procedure was carried out uneventfully, and the IUD was removed. Fetal viability was confirmed after the procedure. At the time of this report, the patient was in the 23rd week of gestation, and the pregnancy was progressing without any problems. Conclusion: Laparoscopic removal of perforated IUD during pregnancy under regional anesthesia is a feasible and safe option that should be considered when needed.
AB - Study Objectives: To describe and demonstrate a technique for laparoscopic removal of a perforating intrauterine device (IUD) during pregnancy, and to provide tips to facilitate safe laparoscopic surgery during pregnancy. Design: Video presentation of the technique for laparoscopic removal of a perforating IUD in a pregnant woman. Setting: Department of Neuroscience, Reproductive Sciences, and Dentistry, University of Naples Federico II, Naples, Italy. Intervention: A 30-year-old woman, gravida 3, para 2, with a copper T IUD (Nova T 380; Bayer, Leverkusen, Germany) perforating the left adnexa presented to the emergency room complaining of left lower quadrant pain. The patient had the IUD inserted by her gynecologist 3 months before the onset of the symptoms. Ultrasound revealed a 6-week intrauterine pregnancy with the presence of fetal cardiac activity along with the IUD perforating the left adnexa. The patient returned at 11 weeks of gestation complaining of worsening abdominal pain and excruciating left lower quadrant pain. She was scheduled for laparoscopic excision of the perforating IUD [1-3]. Considering her pregnancy, laparoscopy under regional anesthesia was performed in the minimal Trendelenburg position at 12 degrees, through open laparoscopic access [4]. Intra-abdominal pressure of 8 mmHg and ultrasound energy to cut and coagulate, avoiding monopolar/bipolar energy owing to the presence of a copper IUD, were used. The IUD and tube were extracted in an endobag through umbilical access, under a 5-mm, 0-degree telescope in left lateral access [5]. The procedure was carried out uneventfully, and the IUD was removed. Fetal viability was confirmed after the procedure. At the time of this report, the patient was in the 23rd week of gestation, and the pregnancy was progressing without any problems. Conclusion: Laparoscopic removal of perforated IUD during pregnancy under regional anesthesia is a feasible and safe option that should be considered when needed.
KW - IUD perforation
KW - Laparoscopy
KW - Pregnancy
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U2 - 10.1016/j.jmig.2019.03.012
DO - 10.1016/j.jmig.2019.03.012
M3 - Article
C2 - 30914327
AN - SCOPUS:85064877369
VL - 26
SP - 1013
EP - 1014
JO - Journal of Minimally Invasive Gynecology
JF - Journal of Minimally Invasive Gynecology
SN - 1553-4650
IS - 6
ER -