Abstract
Video Objective The objective of this video is to demonstrate a laparoscopic technique for surgical management of an interstitial ectopic pregnancy. Setting A patient with a history of a right ectopic pregnancy that was treated with methotrexate administration 4 years prior, presents with a right two-centimeter interstitial ectopic pregnancy. After extensive counseling, the patient declined medical treatment with methotrexate and desired surgical management with preservation of her fertility. Interventions Laparoscopically, the fallopian tube and utero-ovarian ligament were ligated. In a purse string fashion, the interstitial ectopic pregnancy was isolated. A monopolar hook was used to incise the cornua and the ectopic pregnancy tissue was evacuated using a suction irrigator. The uterine defect was closed to insure hemostasis. Conclusion In a selective patient population, a laparoscopic cornuostomy is an option for treatment of an interstitial ectopic pregnancy. This is particularly true for a small interstitial ectopic where a wedge resection may be impossible without significant damage to the uterus. It is still important to follow the quantitative beta human chorionic gonadotropin levels to zero to insure resolution of the pregnancy.
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