ECTOPIC PREGNANCY is a pregnancy that grows in the fallopian tube, not the uterus. If the pregnancy continues and the tube ruptures, there may be life-threatening intraabdominal bleeding. Even with the modern practice of medicine, the rupture of the ectopic pregnancy is still one of the leading causes of gynecological deaths in the United States
OPERATIVE LAPAROSCOPIC SURGERY. The standard of care is to control the bleeding and remove the ectopic pregnancy. Prior to the late 1980's, this was accomplished by first making a large incision in the woman's abdomen and "looking" to find if there was a swollen fallopian tube containing the ectopic. With the advent of advanced laparoscopic technique, the ectopic pregnancy can be identified with only a small incision below the umbilicus (navel).
OPERATIVE LAPAROSCOPIC SURGERY. Today, an advanced operative laparoscopist can remove the ectopic pregnancy, preserve the fallopian tube, and send the patient home. The first step of this technique involves making a linear slit into the fallopian tube over the ectopic with a monopolar needle tip.
OPERATIVE LAPAROSCOPIC SURGERY. The second step involves teasing out the ectopic pregnancy intact, and then irrigating the incision to make sure it is free of any ectopic tissue. The appropriate followup is for the patient to be seen in the office and have serial blood tests of the pregnancy hormone, Beta-HCG. Within a few weeks, the pregnancy hormone should not be measureable.
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