LAPAROSKOPSKI KIRUR[KI ZAHVATI U TRUDNOĆI

VIŠNJA NESEK ADAM, VIVIANA MRČIĆ, ALEKSANDRA SMILJANIĆ, ZORAN ČALA

Razvojem laparoskopske kirurgije broj kontraindikacija za izvođenje kirurških zahvata sve je manji. U samim počecima laparoskopske kirurgije trudnoća se smatrala apsolutnom kontraindikacijom za izvođenje kirurških zahvata ovom tehnikom ponajprije zbog nepoznavanja utjecaja CO2-pneumoperitoneja na fetus. Unatrag nekoliko godina u literaturi postoje podaci o uspješnosti izvođenja laparoskopskih zahvata i u trudnoći. Od 1992. godine kada je učinjena prva laparoskopska kolecistektomija u Hrvatskoj u Kirurškoj klinici OB »Sveti Duh«, laparoskopskom tehnikom operirane su tri trudnice, kod dvije je učinjena laparoskopska kolecistektomija, dok je kod jedne izvršeno laparoskopsko odstranjenje crvuljka. Rezultat: U sve tri bolesnice operacija i poslijeoperacijski tijek protekli su bez komplikacija, a trudnoće su završene u terminu rođenjem zdrave djece.

Summary. With the development of laparoscopic surgery, number of contraindications has become less and less. At the beginning of laparoscopic surgery pregnancy was considered an absolute contraindication to laparoscopic surgery, because of unknown influence of CO2-pneumoperitoneum on fetus. Over the past few years, in literature there have been several case reports of successful laparoscopic surgery in pregnancy. Since 1992 when the first laparoscopic cholecystectomy was done at the University Department of Surgery of Sveti Duh General Hospital in Zagreb, three pregnant women were managed successfully laparo- scopically. Two laparoscopic cholecystectomies, and one laparoscopic appendectomy during pregnancy, were performed. Results: In all three patients, there were no complications during and after surgery. Pregnancies were completed at term spontaneously, delivering healthy children.