Treatment of ectopic pregnancy by operative laparoscopy

Most surgical procedures used to treat ectopic pregnancies can be performed laparoscopically. In the case of ampullary ectopics, tubal damage is minimized and therefore salpingotomy or salpingostomy is the preferred procedure. Salpingectomy may be performed when the anatomy is distorted to a degree that preclides reconstructive surgery on the affected tube or if the patient does not desire future fertility. Laparoscopic salpingectomy may prove technically difficult for those inexperienced with operative laparoscopy. However, the use of staples during salpingectomy may make the procedure somewhat easier. From July 1991 to February 1992 we attempted to treat tubal pregnancies by operative laparoscopy at Chang Gung Memorial Hospital. In 10 of the 24 cases, the technique of laparoscopic salpingectomy using the automatic stapling device, Endo GIA(TM)30, was evaluated. No complications related to surgery occurred during this series. Our conclusion is that operative laparoscopy should be considered an alternative to laparotomy for the treatment of tubal pregnancy and the use of Endo GIA(TM)30 staples may be helpful in these procedures.