Page 41 - World Journal of Laparoscopic Surgery

Secondary Live Abdominal Ectopic Pregnancy
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adherent to the lateral pelvic wall and sent for histopathology. (Fujishita et al., 1980; Vermesh et al., 1989; Brumsted et al., 1988 ).
Right ureter peristalsis visualized. Homeostasis was achieved. Conclude that laparoscopic management of ectopic pregnancy
Abdominal drain was introduced. The postoperative period was results in less postoperative adhesions, significantly less blood loss,
uneventful (Fig. 1). reduced postoperative analgesia, and reduced cost. Consequently,
laparoscopy is the preferred option in the surgical management of
ectopic pregnancy. However, in a critically ill patient, laparotomy
may continue to have a role because of its swiftness to access the
abdomen and securing bleeding vessels. Patients with ectopic
pregnancy in the ampulla of the tube are the ideal candidate for
salpingostomy. Linear salpingostomy can be tried out but not very
successful in the management of a pregnancy lodged in isthmus
because lumen is so small that it erodes muscularis. The prognosis
of the patient with an ectopic pregnancy is good for those with an
early diagnosis. The earlier the diagnosis is made, and treatment is
administered higher the likelihood of subsequent fertility.

conclusIon
With this case report, we highlighted, the medical emergency that
diagnosed should be managed promptly. Proper preoperative
evaluation, use of systemic methotrexate, availability of
multidisciplinary surgical team and proper operative technique
like minimal invasive surgery is invaluable in modern era when
incidence of ectopic pregnancy is increasing due to parallel increase
in etiological factor-like sexually transmitted diseases and assisted
reproductive techniques by early detection with transvaginal
ultrasound and CT scan which can reduce maternal mortality
and morbidity, offer the couple a more optimistic outlook for
subsequent reproductive potential and reduce mental, emotional
trauma to the patient.

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