What surgical techniques and safety measures are important to consider when operating in a pregnant patient? In this episode of the BackTable OBGYN podcast, Dr. Craig Sobolewski, a minimally invasive GYN surgeon at Duke, speaks with host Dr. Mark Hoffman about the intricacies of laparoscopic surgery in pregnant patients.

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SYNPOSIS

The surgeons delve into the critical importance of understanding anatomy and ensuring proper exposure during surgeries, particularly the challenges and techniques for operating during pregnancy. Key discussions include the use of liver retractors, the management of symptomatic ovarian cysts, and the methods for performing and evaluating abdominal cerclages. They also explore the physiological changes in pregnant patients and the adjustments needed for anesthesia, laparoscopic entry, pressures during surgery, and pre/post-operative care.

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TIMESTAMPS

00:00 - Introduction

07:20 - Laparoscopy in Pregnant Patients

11:23 - Common Surgeries During Pregnancy

15:56 - Laparoscopic Surgery Techniques

24:04 - Physiologic Changes in Pregnancy

27:33 - Access Methods and Pressure Considerations

28:53 - Managing Torsion and Cysts in Pregnancy

30:21 - Energy Use and Safety in Pregnant Patients

31:38 - Preoperative and Postoperative Care

34:15 - Cerclage Procedures and Counseling

47:46 - Professional Reflections and Conclusions