Laparoscopic management of ectopic pregnancy have been described extensively in last several years. These methods have been associated with low morbidity, early recovery, and short hospital stay. But most of the reports restricts the application of these technique to patients with hemodynamically stable with small amount of free peritoneal blood, unruptured ampullary and isthntic ectopic pregnancy, and excludes in patients with interstitial pregnancy and with large amout of peritoneal blood. Because of these restrictive entry criteria, the general applicability of laparoscopic methods to unselected cases of ectopic pregnancy has been questioned. We conducted this study whether this technique can be applicable in unselected cases of ectopic pregnancies.
We have experienced 188 cases of laparoscopic surgery in 187 patients with ectopic pregancy. Among the procedures, salpingectomy was performed most frequently(82.4% ). Six patients with cornual pregnancy was successfully managed laparoscopically. Fourteen patients with prior laparotomies over 2 times and twenty three patients with free peritoneal blood over 500m1 were managed successfully with laparoscopic operations without difficulties. Of 187 patients, complication occurred in 10 patients, four of them needed additional procedures, laparotomy for failed laparoscopic procedures in two cases, and additional laparoscopic operation in two patients. One patient with intraligamentary pregnancy, initial procedure has failed to identify the,location of ectopic pregnancy, and in one patient with linear salpingotomy, addtional laparoscopic salpingectomy was needed for bleeding control from salpingotomy sites. Hospital stay was averaged 2.9 days and the operation time was shortened to laparotomy. Laparoscopic treatment of ectopic pregnancy was simple and effective with fast recovery even in patients with pelvic adhesions due to prior operations, ruptured ectopic pregnancies with moderate intraperitoneal free blood, and in patients with interstitial pregnancy with relatively free of complications.
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