title: Hemostatic Techniques for Laparoscopic Management of Cornual Pregnancy: Double-Impact Devascularization Technique.
abstract: Cornual pregnancy is a rare form of ectopic pregnancy, accounting for up to 2% to 4% of all ectopic pregnancies, with a mortality range of 2.0% to 2.5%. Hemorrhage is a key concern in the management of such pregnancies. Traditional treatment options include a conservative approach, failing which patients are offered surgical options such as cornual resection at laparotomy, which carries a high risk of hysterectomy. In recent years newer laparoscopic cornual resection or cornuotomy techniques have been used successfully to achieve better outcomes with fewer complications. We present the double-impact devascularization (DID) technique for laparoscopic management of cornual ectopic pregnancies. This technique permits hemostatic control by compression effect, which in turn allows reduction in procedure-related patient morbidity and mortality. We also provide an overview of other reported methods of hemostatic control used in similar laparoscopic procedures. DID appears to be a useful, safe, minimally invasive technique that can be used in both laparoscopic and open surgical procedures.
authors.affiliation: Department of Obstetrics and Gynaecology, Birmingham Women's NHS Foundation Trust, Birmingham, United Kingdom.
authors.forename: Yousri
authors.initials: Y
authors.lastname: Afifi
authors.affiliation: University of Birmingham, Birmingham Women's NHS Foundation Trust, Birmingham, United Kingdom; Department of Obstetrics and Gynaecology, Birmingham Women's NHS Foundation Trust, Birmingham, United Kingdom. Electronic address: Ayesha_mahmud@hotmail.com.
authors.forename: Ayesha
authors.initials: A
authors.lastname: Mahmud
authors.affiliation: Department of Obstetrics and Gynaecology, Birmingham Women's NHS Foundation Trust, Birmingham, United Kingdom.
authors.forename: Alfia
authors.initials: A
authors.lastname: Fatma
mesh_terms: D000328:Adult; D042241:Early Diagnosis; D005260:Female; D005865:Gestational Age; D006489:Hemostatic Techniques; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D011247:Pregnancy; D065173:Pregnancy, Cornual / Q000175:diagnosis / Q000601:surgery*; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Cornual; Ectopic pregnancy; Gynecology; Hemostatic; Laparoscopy