Salpingectomy for cornual ectopic pregnancy
by Jain Nutan, Jain Vandana

Comprehensive Video Atlas of Laparoscopic Surgery in Infertility and Gynecology

by Nutan Jain
About Video

This video is case of a 29-years-old female present complaints amenorrhea two months and dull pain in abdomen. Sonography: empty uterine cavity, eccentric gestational sac seen in right adnexa just near the cornual end of uterus, separate from ovary. Urinary pregnancy test positive, beta-hCG-455 IU/L. Presumptive diagnosis: right cornual ectopic pregnancy. Port placement: patient laid in modified lithotomy position under GA. Four ports laparoscopy done, all 5 mm ports except camera port which is 10 mm. Surgical procedure: uterus is normal shape, size and position. A right sided intact cornual ectopic pregnancy noted. Left ovary was adhered to ovarian fossa and left tube by flimsy adhesion. These flimsy adhesions removed using blunt hook scissor and a good relationship maintained between left tube and ovary for future reproduction. As the patient is having one issue and other tube is normal and showing patency so decision for salpingectomy taken. Using harmonic ACE fallopian tube transected starting at a point just medial to the cornual ectopic pregnancy and going through the mesosalpinx up to the lateral free end. To remove the fallopian tube, we stretch it out between the two lower ports and then make successive spiral cuts in its entire length, so that when the tube is removed, it collapses and comes out easily through the 5 mm port. Specimen sent for HPE. Thorough suction irrigation and lavage done. Complete hemostasis achieved. HPE report confirmed ectopic gestational contents. Patient was advised for fertility after 6 months of the procedure.

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