Interstitial Ectopic Pregnancy

Abstract

Study Objective The objective of the video is to share a laparoscopic approach to resection of ectopic (interstitial) pregnancy in patient with history of exploratory laparotomy, tubal ligation and reversal as well as ventral hernia repair. Design The patient underwent laparoscopic resection of ectopic (interstitial) pregnancy. She has been seen at a 4-week postoperative visit. Setting The patient is placed in the dorsal lithotomy position. Arms are tucked. A single video screen is placed at the foot of the bed. A total of 4 ports are used including three 5 mm ports and one 12 mm port (suprapubic). Patients or Participants The patient was selected for this surgery based on ultrasound findings and after review of her surgical history. Interventions Laparoscopic resection of ectopic (interstitial) pregnancy. Measurements and Main Results The patient presented with a right ectopic (interstitial) pregnancy. Crown rump length measured 1.65 cm. Her pre-operative HCG level was 25,634. The patient underwent laparoscopic resection of ectopic pregnancy (interstitial). Her HCG level trended down to 4 at four weeks after surgery. Conclusion Resection of ectopic (interstitial) pregnancy can be performed safely using laparoscopy in patients with extensive surgical histories. In this video, we show how the pregnancy is excised, followed by curettage, and tissue removal. The suprapubic port is an effective placement for curettage of the ectopic bed as well as for suturing the uterus after resection of the ectopic pregnancy.