8974 Laparoscopic Loop and Stitch Technique in Tubal Stump Ectopic Pregnancy

Abstract

<h3>Study Objective</h3> To describe a new technique of loop and stitch technique in tubal stump ectopic pregnancy <h3>Design</h3> Description of technique with narrated video clip <h3>Setting</h3> Academic tertiary hospital <h3>Patients or Participants</h3> 33-year-old female with tubal factor infertility was diagnosed with tubal stump ectopic pregnancy at 5+3 weeks period of gestation. She had history of right tubal ectopic conceived through IVF in the past. Serum beta HCG showed an inadequate rise of 21%. Diagnosis was facilitated by 2D and 4D ultrasound findings. <h3>Interventions</h3> Laparoscopy confirmed our diagnosis of ectopic in right tubal stump. Diluted Vasopressin was injected at the base of stump. Circumferential stitches were taken all around the base of the stump using barbed vicryl suture. Ectopic mass was completely removed with the tubal remnant using harmonic scalpel. Serosal breach was repaired with same suture. Contralateral salpingectomy was also done. <h3>Measurements and Main Results</h3> Laparoscopic loop and stitch technique is minimally invasive thus avoiding cornual wedge resection and blood loss. Uterine myometrium was saved from damage thus preventing future major obstetric catastrophe like uterine rupture and morbidly adherent placenta. <h3>Conclusion</h3> Diagnosis of stump ectopic requires high degree of suspicion with history, examination and ultrasound findings. This new minimally invasive technique of loop and stitch which when offered timely enhances women's future fertility and reproductive outcomes.