To analysis the feasibility, safety, and impact on clinical in pregnancy outcomes of single-port transumbilical laparoscopic surgery for adnexal masses in pregnancy.

A total of 14 cases underwent laparoendoscopic single-site surgery for adnexal masses of the West China Second University hospita in Dec. 2018 to Jul. 2021.To observe its pregnancy outcomes and analyze the safety of surgery by collecting operation time, intraoperative blood volume, hospitalization, postoperative complications, postoperative pain, postoperative analgesic medication rate, postoperative maximum body temperature, postoperative anus exhaust time, postoperative pathological type, perioperative complications, incision healing, follow-up delivery, childbirth week, mode of delivery, fetal malformation, intrapartum score, fetal disease, umbilical hernia, etc.

Among the 14 cases of pregnancy with adnexal mass, 13 cases were pregnancy with ovarian mass, 1 case was intrauterine pregnancy with tubal pregnancy, the operation process was smooth, all of them were not converted to laparotomy or traditional laparoscopy.In 14 patients, the average operation time was(112.93±31.16)min, the average intraoperative bleeding was (27.14±29.40) ml, the average postoperative anal exhaust time was 1. (1.30±0.37)days, and the highest postoperative body temperature was 36.5-37.4℃. All the incisions healed well and there was no incision infection. And no complications such as abortion and infection occurred during the perioperative period. Our study analyzed the postoperative pain scores of all patients, the results showed that the average score of all patients was (2.93±1.81), and the number of patients with scores of 1-3 were 12 cases(85.71%). At the same time, the results showed that the ratio of analgesics who used transumbilical single-port laparoscopic surgery to treat pregnancy with adnexal mass was 1 in 14 patients(7.14%, 1/14). The delivery status of the patients was followed up, and the results showed that 9 patients finally gave birth successfully(64.28%, 9/14), while the other 5 patients(35.71%, 5/14)terminated their pregnancy. The results of pregnancy mode showed that 4 cases (44.44%, 4/9) were normal delivery and 5 cases(55.56%, 5/9) were cesarean section(One patient was given a cesarean section 2 days after oxytocin induction at 41 weeks of gestation, 1 case of breech pregnancy was performed at 39^{+ 1} week gestation, and 1 case of breech pregnancy after in vitro fertilization-embryo transfer was performed at 37^{+ 3} weeks the patient resolutely requested a cesarean section, the other two cases were requested by the patient), the causes of cesarean section were not related to laparoendoscopic single-site surgery with adnexal masses. The results of fetal morphological observation showed that all 14 fetuses had no malformations, and there was no umbilical hernia during pregnancy, delivery, and postpartum.

Single-port transumbilical laparoscopic surgery for pregnancy complicated with adnexal mass has the advantages of less trauma, quick recovery, safe and feasible technique, and does not affect the subsequent pregnancy and delivery mode. At the same time, the umbilical stoma is like an open laparoscopic operation, which effectively avoids the injury of the first blind puncture operation (pneumoperitoneum needle or trocar), thus improving the safety of the mother and fetus, which is worth popularizing.