A laparoscopic approach can be applied to most cases of ectopic pregnancy.
Recent studies have demonstrated lower cost and morbidity associated with laparoscopic treatment of ectopic pregnancy. However, the applicability of these techniques to unselected cases of ectopic pregnancy has not yet been proved. To test the efficiency of the laparoscopic approach, an attempt was made to apply these techniques to all patients who presented with ectopic pregnancy at a medical center during a 6-month period and who met the entry criteria of hemodynamic stability; location other than abdominal with fetus, interstitial, or cervical; and visibility of the mesosalpinx. None of the 22 patients referred to the study had to be excluded because of these criteria, indicating the relative infrequency of these contraindications. All were treated successfully by laparoscopic salpingectomy (N = 12), salpingostomy (N = 8), or removal of implantations from peritoneal surfaces (N = 2). The average size of the ectopic gestation was 3.9 cm, the average amount of hemoperitoneum was 168 mL, the average additional blood loss attributable to the procedure was 30 mL, and the average drop in hematocrit postoperatively was 4.7%. The average hospital stay was 1.1 days, and patients were released for work in 1-2 weeks. An analysis of the three patients not referred to the study indicated that they may have been appropriate candidates for laparoscopic resection. This study indicates that the majority of unselected patients with ectopic pregnancy may be treated by laparoscopic procedures, with low cost and low morbidity.
Silva
P D
PD
Department of Obstetrics and Gynecology, Gundersen/Lutheran Medical Center, La Crosse, Wisconsin.
D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008722:Methods; D011183:Postoperative Complications; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000175:diagnosis / Q000601:surgery*