Gasless laparoscopic management of ovarian cysts during pregnancy
Bibliographic record
Abstract
Ovarian cysts are commonly found on ultrasound examination during early pregnancy. Until recently, laparoscopy during pregnancy was not encouraged, but some reports have appeared on its safety [1], [2]. In this study (Canadian Task Force classification III), the safety of gasless laparoscopic ovarian cystectomy during pregnancy was evaluated retrospectively. Thirteen patients underwent gasless laparoscopic surgery with subcutaneous lifting of the abdominal wall. General anesthesia was performed in all patients, of whom 11 also received epidural anesthesia and 2 received a muscle relaxant. The 13 procedures were performed using the transperitoneal technique. After the cyst was punctured and its contents aspirated endoscopically, the adnexa was pulled through the port site and cystectomy was performed. The adnexa was then repositioned in the peritoneal cavity. Patient characteristics, pathologic diagnoses, and maternal and neonatal outcomes are presented in Table 1. All operations were performed between 10 and 17 weeks of pregnancy: 4 at 10 weeks, 3 at 11 weeks, 2 at 12 weeks, 2 at 14 weeks, 1 at 16 weeks, and 1 at 17 weeks. Main tumor diameters ranged from 54 to 130 mm. Dermoid cysts were found in 11 of the 13 patients, and there were 1 corpus luteum cyst and 1 serous cystadenoma. Postoperative complications included uterine contractions in 3 women and vaginal bleeding in 4 women, but these symptoms resolved shortly after surgery. Complications following discharge included 2 threatened preterm deliveries and 2 cases of pre-eclampsia; however, all complications were successfully managed at the outpatient clinic. All patients were delivered between 37 and 40 weeks of pregnancy. One neonate was delivered at 39 weeks with a low birth weight that was still adequate for gestational age, and another had mild hyperbilirubinemia. None of the neonates had serious complications or anomalies. It has been suggested that conventional laparoscopy, with insufflation of carbon dioxide, can lead to fetal complications such as fetal hypercarbia and fetal acidosis [1], and that premature labor can occur from the increased intra-abdominal pressure. Gasless laparoscopy, however, is not associated with risks arising from carbon dioxide insufflation. Patients in this study did not experience severe postoperative complications. All patients were delivered at term from healthy neonates. Given the small number of patients, the maternal and fetal safety of the procedure can not be determined. However, this study suggests that laparoscopic surgery can be safely performed for benign ovarian cysts discovered during pregnancy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".