title: Laparoscopic Management of Interstitial Ectopic Using Simple and Safe Technique: Case Series and Review of Literature.
abstract: 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.
  
  
  METHODS
  Case series of five consecutive cases.
  
  
  METHODS
  Endoscopy unit in Alexandria University Hospital and Alexandria New Medical Center.
  
  
  METHODS
  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.
  
  
  RESULTS
  The devascularization sutures together with uterotonics make the surgical treatment of interstitial ectopic easy and safe. This simple technique minimizes blood loss and decreases necrosis that follows excessive use of diathermy. This was demonstrated successfully in different types of interstitial ectopic. We did not remove any part of the uterus during surgery. Clinical criteria of the study cases were discussed. Type, size, blood loss and complications, and duration of the surgery were documented.
  
  
  CONCLUSIONS
  Operative laparoscopy using sutures and uterotonics is safe and sustainable approach in treatment of interstitial ectopic pregnancy.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, El Shatby Maternity University Hospital, Alexandria University, 20 Saboungy Street, Saba Bacha, Alexandria, Egypt ; New Mexico University School of Medicine, Albuquerque, NM USA.
authors.forename: Tamer Hanafy
authors.initials: TH
authors.lastname: Said
keywords: Cornual; Interstitial ectopic pregnancy; Laparoscopy; Safety