Gasless laparoscopic surgery for ovarian cyst in a second trimester pregnant patient with a ventricular septal defect

Background: Ovarian cysts are estimated to occur in 4.1% of second trimester and third trimester obstetric ultrasonographic examination. Laparoscopy has not been widely performed during pregnancy, especially after the first trimester, and laparotomy remains the standard of care. Herein, we report a use of gasless laparoscopy in the management of an ovarian cyst during second trimester of pregnancy. Case: A 21-year-old primigravida woman initially presented for antenatal care at 6 weeks' pregnancy. She had an underlying small subaortic ventricular septal wall defect with a functional class I. A left ovarian cyst was found during ultrasound examination. Elective gasless laparoscopic surgery due to persistence ovarian cyst was performed at 14th week of gestation without complications. The subsequent antenatal course was unremarkable. The pregnancy carried to term with uneventful maternal and fetal outcomes. Conclusions: Gasless laparoscopy is an alternative procedure for the management of ovarian cyst during pregnancy. This allows laparoscopic surgery that is minimally invasive for both the mother and the fetus.