Abstract
To show how interstitial pregnancy can be safely managed with a laparoscopic resection.
Keywords: Laparoscopy, ectopic pregnancy, interstitial pregnancy, minimal invaziv surgery
Introduction
Our aim was to demonstrate how interstitial pregnancy can be treated with laparoscopy. Interstitial pregnancy is one of the more uncommon forms of ectopic pregnancy. It contributes only 2-4% of all ectopic pregnancies (1). Mortality rate is 6-7 times higher than that in classical ectopic pregnancy (2).
The patient was admitted to our clinic with vaginal bleeding. The woman had a 7-week pregnancy in the interstitial region of the uterus. This interstitial pregnancy was safely managed laparoscopically.
We demonstrate a totally laparoscopic approach to an advanced interstitial pregnancy with several key strategies to minimize blood loss:
1. Coagulation of interstitial pregnancy and uterine junction,
2. Use of grasper device to enucleate the gestational sac,
3. Suture the uterine layers with vicryl sutures,
4. Removing the specimen from the optical trocar with a glove bag.
Interstitial pregnancies may be managed with laparotomy. We have demonstrated a safe laparoscopic surgery technique for interstitial pregnancy with minimal instrument use and low cost. The ultrasound images of the patient are shown in Figure 1, 2.
Figure 1.
Transvaginal ultrasound image showing a gestational sac in the outer left margin of the uterus
Figure 2.
Transvaginal ultrasound revealed vascularity surrounding the gestation
Video 1.
https://www.doi.org/10.4274/jtgga.galenos.2020.2020.0013.video1
Footnotes
Conflict of Interest: No conflict of interest was declared by the authors.
Financial Disclosure: The authors declared that this studyreceived no financial support.
References
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