Single-suprapubic Incision Minimally Invasive Surgery in Pregnancy – A Novel Approach and Case Report

Ovarian cysts are increasingly diagnosed during pregnancy due to the availability and routine use of ultrasound in antenatal care. Whilst expectant management may be considered, surgical intervention may be required due to mass effect symptoms, ovarian accidents such as torsion or rupture, or suspicion of malignancy. Modern techniques have moved toward minimally invasive surgery due to reduced morbidity and enhanced postoperative recovery. However, laparoscopy in pregnancy may still be technically difficult due to operative challenges such as the gravid uterus, giant ovarian masses (>10 cm), or the presence of adhesions. Ovarian dermoid cysts may also contain solid material, such as bone or hair, that precludes extraction via traditional laparoscopic incisions. Rather than reverting to laparotomy, we describe the use of a minilaparotomy combined with laparoscopy within a suprapubic incision – single-suprapubic incision minimally invasive surgery (SIMS) in pregnancy. Thus, the benefits of laparoscopy are retained whilst avoiding the need for open surgery.