A spontaneous heterotopic pregnancy presenting with acute abdomen treated with natural orifice transluminal endoscopic surgery procedure: Case report

Doğan, Keziban; Kaya, Cihan; Ilıman, Derya Ece; Karaca, İbrahim; Cengiz, Hüseyin

doi:10.4274/tjod.galenos.2019.76300

Cited by 5 publications

(3 citation statements)

References 15 publications

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“…In 2005, Ghezzi et al [ 14 ] reported a single-port laparoscopic salpingectomy for EP. Keziban et al [ 15 ] reported a spontaneous heterotopic pregnancy presenting as an acute abdomen, which was successfully treated using vaginal natural orifice transluminal endoscopic surgery (vNOTES). vNOTES has shown promise in treating various adnexal lesions.…”

Section: Discussionmentioning

confidence: 99%

The learning curve of laparoscopic single-site salpingectomy with conventional laparoscopic instruments: A retrospective cohort study

Huang,

Zhang,

Yang

et al. 2024

Medicine

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Tubal pregnancy is a common cause of maternal mortality in early pregnancy. Transumbilical laparoendoscopic single-site surgery (TU-LESS) has gained popularity due to its safety and aesthetic advantages. However, the lack of affordable disposable entry platforms hinders its widespread adoption. This study aimed to investigate the learning curve of tubal pregnancy removal using single-incision multiport (SIMP) laparoscopy and provide guidance for novice gynecologists. A retrospective analysis was conducted on cases of ectopic pregnancy (EP) diagnosed at Dongguan Songshan Lake Central Hospital from June 2020 to June 2022. The analysis included 50 cases, with 25 undergoing single-port laparoscopy and 25 undergoing conventional laparoscopy (CL). Various indicators, including body mass index (BMI), previous pregnancies, mass size, hemoglobin levels, surgical duration, and complications, were collected. Learning curve analysis using the cumulative sum (CUSUM) technique was performed to assess procedural proficiency. There were no significant differences in patient characteristics or complications between the 2 groups. However, the single-port laparoscopy group exhibited a statistically significant longer average surgical time (41.60 ± 13.38 minutes) compared to the conventional laparotomy group (32.96 ± 7.32 minutes). The CUSUM analysis demonstrated a decline in surgical time after the completion of approximately 11 cases, indicating an improvement in SIMP laparoscopy surgical proficiency. SIMP laparoscopy for tubal pregnancy removal achieved similar safety outcomes as CL. Notably, the CUSUM analysis revealed that proficiency in single-port laparoscopy could be achieved after approximately 11 cases, leading to stable surgical times. These findings serve as valuable guidance for novice gynecologists interested in adopting single-incision laparoscopy.

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Section: Discussionmentioning

confidence: 99%

The learning curve of laparoscopic single-site salpingectomy with conventional laparoscopic instruments: A retrospective cohort study

Huang,

Zhang,

Yang

et al. 2024

Medicine

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“…Compared with existed case reports and case-series studies, this study could provide a relatively higher level of evidence for clinician to choose laparoscopic surgery for those patients with HP. Besides, this study could provide some insight to focus on the efficacy and safety of different types of laparoscopy, such as a natural orifice transluminal endoscopic surgery (NOTES) reported in a case report ( 39 ), in the future.…”

Section: Discussionmentioning

confidence: 99%

Comparison of laparoscopic and open approach in the treatment of heterotopic pregnancy following embryo transfer

Chen

Zhu²,

Xie³

2022

Front. Surg.

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PurposeHeterotopic pregnancy (HP) is a rare disease with the coexistence of an intrauterine and ectopic embryos. There is no consensus on the optimal treatment of HP at present. This research aimed to compare the perioperative and pregnancy outcomes of laparoscopic (LA) and open approach (OA) in patients with HP after embryo transfer.MethodsWomen with HP receiving surgical treatment (LA or OA) were retrospectively recruited in this study between October 2006 and December 2020. The demographic, perioperative and obstetric data were collected and compared between LA and OA group.ResultsTotally, 86 patients were included in this study. Among these patients, 62 underwent LA and 24 underwent OA. There was an increase in the adoption of LA between the 2006–2012 period and the 2013–2020 period [25% (6/24) vs. 90% (56/62), p < 0.001]. Compared with OA, patients treated by LA had much less blood loss [20 (10–50) vs. 30 (20–50) ml, p = 0.036] and fewer days of hospital stay [5.0 (4.0–7.3) vs. 9.5 (7–15.3) days, p < 0.001], but a relatively higher cost (15,580 ± 3196¥ vs. 11,717 ± 3820¥, p < 0.001). During the laparoscopic procedure, no one needed to be converted to open surgery. However, the rates of first trimester miscarriage, preterm, cesarean section, birth weight, 1- and 5-min Apgar were similar between LA and OA group (all p > 0.05).ConclusionsCompared with open approach, laparoscopy was shown to provide a comparable pregnancy outcomes and a better performance on perioperative outcomes in the treatment of HP patients with embryo transfer.

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“…However, recent data reported a similarity in terms of intrauterine pregnancy after 24 months and 2-year recurrency of ectopic pregnancy. However, the persistency of trophoblast was 1.8% for salpingectomy and 12% for salpingostomy [12].…”

Section: Introductionmentioning

confidence: 93%

Early diagnosis and surgical management of heterotopic pregnancy allows us to save the intrauterine pregnancy

Cucinella

Gullo

Etrusco

et al. 2021

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Heterotopic pregnancy is a rare but intriguing disease, which poses a high risk for pregnant women and for intrauterine pregnancy. Clinically, it is mainly characterized by pain and vaginal bleeding. b-hCG serum dosage is used to detect the pregnancy, but transvaginal ultrasound is needed to diagnose heterotopic pregnancy. From all the risk factors, the assisted reproductive treatments represent the most important, especially when multiple embryos are transferred. Patients with a heterotopic pregnancy are at risk of having a spontaneous or medically induced abortion, and for this reason appropriate and tailored treatment should be considered, pursuing the optimal risk/benefit ratio. Although conservative treatments are available in the case of only extrauterine pregnancy, such as methotrexate, often the laparoscopic approach seems unavoidable in heterotopic pregnancy. To preserve the intrauterine pregnancy, a conservative treatment is remarkable, both salpingotomy or salpingostomy. In this case report, we present a successful laparoscopic treatment of an extrauterine pregnancy with the prosecution of the intrauterine pregnancy up to the third trimester. In particular, a 25-year-old girl referred to the Villa Sofia Cervello Hospital complaining of abdominopelvic pain and vaginal bleeding for 2 days. The salpingectomy approach was performed, and every anatomical piece was sent for histopathology.

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A spontaneous heterotopic pregnancy presenting with acute abdomen treated with natural orifice transluminal endoscopic surgery procedure: Case report

Cited by 5 publications

References 15 publications

The learning curve of laparoscopic single-site salpingectomy with conventional laparoscopic instruments: A retrospective cohort study

The learning curve of laparoscopic single-site salpingectomy with conventional laparoscopic instruments: A retrospective cohort study

Comparison of laparoscopic and open approach in the treatment of heterotopic pregnancy following embryo transfer

Early diagnosis and surgical management of heterotopic pregnancy allows us to save the intrauterine pregnancy

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