Laparoscopic Management of Interstitial Ectopic Using Simple and Safe Technique: Case Series and Review of Literature

Abstract

Background and Objective To determine the safety and sustainability of operative laparoscopy in surgical management of cornual and interstitial ectopic pregnancy using a simple and practical method. Design Case series of five consecutive cases.Setting Endoscopy unit in Alexandria University Hospital and Alexandria New Medical Center. Patients Between July 2013 and May 2015, five women with interstitial and cornual ectopic pregnancies were admitted for laparoscopic surgical treatment. Methods Full medical and surgical histories were taken. We explained all alternatives for both partners before informed. Patients underwent laparoscopy for management of the corneal ectopic. All surgeries were done by the same surgeon (T.S.) with different assistants. We gave different uterotonics drugs to devascularize the uterus. Two or more devascularization sutures were done on each end of the corneal ectopic. We used monopolar and bipolar electrocoagulation when indicated. We did linear cut of the interstitial ectopic with evacuation of the fetus and placental tissues. Extraction of the conceptus was performed through 10 mm port. Follow-up of the beta-hCG was done weekly till negative results were obtained.

Uterine Rupture in Third Trimester of Pregnancy Following Cornual Resection Due to Ectopic Pregnancy

“…The latest advances in laparoscopic surgery have enabled this condition be resolved laparoscopically as well. Methotrexate pharmacotherapy is also available ( 14 - 18 ). Hysteroscopic methotrexate injection under ultrasonographic guidance has also been described as a treatment option ( 19 ).…”

Comparison between laparoscopic surgery and laparotomy for the treatment of acute ruptured ectopic pregnancy

“…Laparotomy operation is simple, can clearly reveal operation field, and is currently the most widely used way of ectopic pregnancy emergency surgery [1][2]. Laparoscopic surgery is the operation method rising in recent years, the endoscopic equipment enables surgical operation under minimally invasive condition, the vision is clearer and the operation is more delicate, it can choose oviduct excision or embryo removal retaining oviduct, and it is suitable for women at childbearing age and with fertility requirements [3][4]. At present, more and more domestic and foreign scholars have adopted laparoscopic surgery for acute ruptured ectopic pregnancy and achieved positive effect, but there is no report about the stress response caused by the trauma after acute ruptured ectopic pregnancy.…”