Resection of five centimeter cesarean scar ectopic pregnancy and isthmocele repair using vascular clamps

Abstract

The objective of this video is to present a surgical case of resection and repair of a five centimeter cesarean scar ectopic pregnancy. We will highlight the use of laparoscopic vascular bulldog clamps to aid in hemostatic control during the resection. We will also demonstrate the use of laparoscopic suturing and intracorporeal knot tying techniques to repair the hysterotomy incision and help prevent formation of a postoperative isthmocele. We will present the case of a 33 you G4P1021 that presented with a five centimeter cesarean scar ectopic pregnancy. She failed medical management and had a strong desire for future fertility. We will present a surgical approach to the resection and repair of a cesarean scar ectopic pregnancy. We will highlight the use of laparoscopic vascular bulldog clamps to aid in the isolation and temporary occlusion of the vascular supply to aid in the hemostatic resection of the ectopic pregnancy. We will also demonstrate laparoscopic suturing and knot tying techniques to approximate the hysterotomy incision and prevent formation of a post operative isthmocele. Resection of a cesarean scar ectopic pregnancy with repair is a viable treatment option for patients that have failed medical therapy and desire future fertility. Laparoscopic vascular bulldog clamps can aid in a hemostatic excision and repair. Sound surgical principles and laparoscopic suturing techniques can be employed to prevent the formation of a postoperative isthomcele.