Utilization of the Endoloop in Laparoscopic Removal of an Interstitial Ectopic Pregnancy

Abstract

<h3>Study Objective</h3> To demonstrate the use of the Endoloop in the laparoscopic removal of an interstitial ectopic pregnancy. <h3>Design</h3> A surgical video case report. <h3>Setting</h3> An academic hospital in the United States. <h3>Patients or Participants</h3> 32yo G3P1011 diagnosed with an unruptured right interstitial ectopic pregnancy after presenting to an obstetric emergency room with right lower quadrant pain. Ultrasound evaluation showed an approximately 2cm right adnexal pregnancy measuring 6 weeks with fetal heart rate of 144. <h3>Interventions</h3> Laparoscopic removal of right interstitial ectopic pregnancy with assistance of the Endoloop. <h3>Measurements and Main Results</h3> The patient was taken to the operating room for a laparoscopic right salpingectomy using bipolar sealing electrocautery. The interstitial location of the ectopic pregnancy made electrocautery ligation of the right fallopian tube at the cornua difficult given the tissue thickness. The Endoloop was introduced and secured at the right cornua, proximal to the ectopic pregnancy to create a pedicle for ligation. This allowed for removal of the right fallopian tube and the ectopic pregnancy at the right cornua with sharp dissection and unipolar electrocautery while maintaining hemostasis and limiting disruption of the myometrium. <h3>Conclusion</h3> The Endoloop can be utilized for laparoscopic surgical management of an interstitial ectopic pregnancy.