Resection of a Cornual Heterotopic Pregnancy Using Single-Site Laparoscopic Techniques

Abstract

<h3>Study Objective</h3> To describe techniques for resection of a cornual heterotopic pregnancy. <h3>Design</h3> Demonstration of surgical technique with narrative video footage using two case examples. <h3>Setting</h3> Academic medical center. <h3>Patients or Participants</h3> A case of an 8-week cornual heterotopic pregnancy with successful delivery of the intrauterine pregnancy and a case of a cornual ectopic at 10 weeks. <h3>Interventions</h3> We demonstrate the use of a "purse string" technique using robotic assisted single incision laparoscopy to resect a cornual heterotopic with minimal blood loss using a 2-0 V-lock suture. Additionally, we review this similar technique with traditional single-site laparoscopic surgery. <h3>Measurements and Main Results</h3> Resection of a cornual heterotopic pregnancy can be successful done using a "purse string" technique. This technique allows for minimal blood loss as well as minimal entry into the myometrium, which allows for minimal manipulation of the concurrent intrauterine pregnancy. <h3>Conclusion</h3> Resection of cornual heterotopic pregnancy can be done using a "purse-string" surgical technique. This technique allows for minimal blood loss in cases where additional techniques for hemostasis cannot be used, such as injection of vasopressin and uterine artery ligation. We also demonstrate that this technique can be successful completed using either traditional or robotic assisted single incision laparoscopic surgery.