title: Laparoscopic management of cervical-isthmic pregnancy: a proposal method.
abstract: OBJECTIVE
  To describe a rare case of a singleton 9-week cervical-isthmic pregnancy (CIP), treated by laparoscopic removal of the ectopic pregnancy and suturing of the uterine site of the ectopic pregnancy with single stitches.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Main general hospital.
  
  
  METHODS
  A 37-year-old woman was admitted for suspected singleton CIP at week 9, following two Cesarean sections. Clinical examination, beta-hCG increase, and transvaginal ultrasonography were used to monitor the suspected diagnosis of an ectopic pregnancy. Following failure of methotrexate administration, surgeons performed a laparoscopy.
  
  
  METHODS
  The CIP removal was performed by laparoscopic incision, enucleating the isthmic mass and suturing the uterine site of the ectopic pregnancy with single stitches.
  
  
  METHODS
  Intraprocedural or postprocedural complications and uterine integrity preservation.
  
  
  RESULTS
  Postoperative recovery period was normal, without intraprocedural or postprocedural complications. Uterine integrity was preserved. No further therapeutic interventions were needed in follow-up.
  
  
  CONCLUSIONS
  In the case of CIP in women interested in minimally invasive treatment, resection of an ectopic pregnancy and suturing of the removal site may be an option to preserve uterine integrity. By improving endosurgical skills, these treatments may be safely proposed avoiding further invasive therapies.
authors.affiliation: Department of Obstetrics and Gynaecology, Vito Fazzi Hospital, Lecce, Italy. andreatinelli@gmail.com
authors.forename: Andrea
authors.initials: A
authors.lastname: Tinelli
authors.forename: Raffaele
authors.initials: R
authors.lastname: Tinelli
authors.forename: Antonio
authors.initials: A
authors.lastname: Malvasi
mesh_terms: D002584:Cervix Uteri; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000601:surgery*; D013536:Suture Techniques; D016896:Treatment Outcome