Surgical considerations of combined laparoscopic cholecystectomy and cesarean delivery

A 32-year-old female, with history of two previous cesarean sections. She was scheduled for an elective cesarean section. The night before surgery, she hada spike of fever and abdominal pain in the epigastrium and felt nauseated. She was brought to the emergency room, and her ultrasound examination revealed edema n the peri- gallbladder area and cholecystitis. A general surgical consult was made, and the opinion was that she needs to be operated urgently. Laparoscopic cholecystectomy was done with initial port placement at Palmer's point with a 5-cm Covidien optical port. Procedure completed with no complication. The obstetric team then made a Pfannenstiel incision to deliver the baby. The delivery was completed in 10 min after the closure of the laparoscopic ports. The patient was in hospital for the next 3 days, and her puerperium was unremarkable. There were no further complications during her stay. The baby was discharged from NICU on the1stpostoperativeday.