Laparoscopy for Cornual Ectopic Pregnancy

Abstract

Background: Ectopic pregnancy rarely occurs in the uterine cornu. When it does, it exposes the affected patient to the risk of death from rupture with intra-abdominal bleeding. Its surgical management is difficult. The primary modalities for treating this condition are surgery in the form of laparotomy and methotrexate administration. They both have advantages and potential shortcomings. An alternative option is operative laparoscopy, which may be preferable to these other approaches under certain circumstances. Cases: Three cases of women with unruptured cornual ectopic pregnancies that were managed by operative laparoscopy, are reported. All pregnancies were advanced, with large cornual masses and high beta-subunit hCG levels. The operative procedure involved use of an endo-GIA (Tyco U.S. Surgical, Norwalk, CT), cautery, endoclips, and Surgicel ( Johnson & Johnson Medical, Inc, Arlington, TX). It was completed without complications. Blood loss was not excessive. Operative time was somewhat prolonged, probably reflecting a long learning curve for this technique. Conclusions: Operative laparoscopy was found to be feasible and safe as a potentially utilitarian alternative to laparotomy or conservative medical management for advanced unruptured cornual pregnancies. It may benefit selected patients whose cardiovascular status is stable and whose advanced cornual pregnancy has not yet ruptured. ( J GYNECOL SURG 27:155)

Novel laparoscopic cornual resection of interstitial pregnancy using the Endo GIA™ Universal Stapler (Medtronic): A series of 12 cases

“…There is a paucity of long‐term fertility data following laparoscopic cornual resection using the Endo GIA ™ Stapler system as none of the authors of the previous 11 published cases had reported follow‐up reviews of their patients. For completion, we have included a picture taken during elective CS showing the cornual stump in our patient who had a previous right laparoscopic cornual resection using Endo GIA™ Universal Stapler two years prior (Fig.…”

“…Laparoscopic cornual resection (cornuectomy) using a stapling device, Multifire Endo GIA ™ Stapler (Medtronic, Watford, UK), was first described by Sergent et al . in 2003, and in total so far, 11 cases have been published in the literature . The Multifire Endo GIA ™ Stapler is an automatic stapler with disposable reloadable cartridges (2, 2.5 or 3.5 mm), which places two triple‐staggered rows of titanium mini‐staples and simultaneously divides the tissue between the two rows.…”

“…cases have been published in the literature. [7][8][9][10][11] The Multifire Endo GIA™ Stapler is an automatic stapler with disposable reloadable cartridges (2, 2.5 or 3.5 mm), which places two triple-staggered rows of titanium mini-staples and simultaneously divides the tissue between the two rows. The device, which is introduced through a 12 mm trocar, has been used safely in a wide variety of surgical procedures such as small bowel resection, cholecystectomy 12 and pulmonary wedge resection.…”