This course provides a comprehensive overview of the challenges MIG-surgeons face when operating on pregnant women or complex pregnancies such as a cesarean scar pregnancy.

We will review the latest information on the impact of minimally invasive procedures such as myomectomy, isthmocele repair, septum resection, metroplasty, and Asherman’s Syndrome, on delivery outcomes and risks of obstetric adverse events (i.e., uterine rupture and placental complications).

We will encourage participants to expand their skillset on laparoscopic (robotic) abdominal cerclage to tackle this complex surgery. Detailed anatomy charts will provide the minimally invasive surgeon with concepts and tools to improve their practice on laparoscopic (robotic) abdominal cerclage.


This course will demonstrate the evidence, imaging, video on endometriosis and adenomyosis, and pregnancy and obstetrical outcome. And we will discuss the information on which to base pre-conceptional counseling and clarify whether and in which cases pregnant women with endometriosis and adenomyosis should be referred to tertiary care centers and followed as high-risk obstetric patients.

Learning Objectives:
After attending this session, the participant will be able to...:
1) Incorporate pivotal steps in managing pregnant women with complex pregnancies, including diagnostic modalities, risk assessment, counseling patients, and executing appropriate management plans; 2) Analyze the data to assess the impact of minimally invasive procedures, such as myomectomy, isthmocele repair, septum resection, metroplasty, and Asherman’s syndrome treatment, on delivery outcomes and obstetric risks; 3) Explore emerging data on endometriosis and adenomyosis in relation to obstetric risks by evaluating the latest research findings, identifying high-risk obstetric scenarios associated with these conditions, and determining the appropriate approaches to preconception counseling and management; and 4) 
Determine referral criteria for high-risk obstetric patients who have undergone minimal invasive surgeries to tertiary care centers for specialized obstetric care, based on their surgical history and factors such as the complexity of the procedure, potential obstetric complications, and the need for specialized monitoring and management.

Presentations:
12:45 pm Welcome, Introduction and Course Overview
Chair: Miriam Hanstede, MD
Spaarne Gasthuis, Harlem, Netherlands

12:50 pm Physiology of Laparoscopic Surgery in Pregnant Patients
Craig J. Sobolewski, MD, Duke University Medical Center, Morrisville, NC

1:10 pm Cesarean Scar Pregnancy Management and Treatment Approaches
Erin Nesbitt-Hawes, Associate Professor, BMED(Hons), PhD

1:30 pm Restoring the Uterine Cavity
Miriam Hanstede, MD, Spaarne Gasthuis, Haarlem, Netherlands

1:50 pm Endometriosis and Adenomyosis: Pregnancy and Obstetrical Outcome
Sukhbir S. Singh, MD, FRCSC, FACOG, Ottawa Hospital, Ottawa, ON, Canada

2:10 pm Laparoscopic Abdominal Cerclage: Indications and Techniques
Jon I. Einarsson, MD, PhD, MPH, Obstetrics and Gynecology Division of Minimally Invasive Gynecologic Surgery, Brigham and Women's Hospital, Boston, MA

2:30 pm Discussion - Questions & Answers - All Faculty

2:45 pm Adjourn