This video demonstrate laparoscopic management of ruptured ectopic pregnancy performed by Dr R K Mishra at World Laparoscopy Hospital. The first successful surgical management of a ruptured tubal pregnancy occurred in April 1883, when the British surgeon Robert Lawson Tait performed a laparotomy and ligated the ruptured tube and the broad ligament. At a time when ectopic pregnancy was associated with a greater than 60% mortality rate, Tait lost only 2 of the first 42 patients on whom he operated. By the 1920s, laparotomy and ligation of the bleeding vessels with removal of the affected tube had become the standard of care, and it remained so until the late 1970s, when operative laparoscopy and salpingostomy replaced laparotomy and salpingectomy. In the 1980s and 1990s, medical therapy for ectopic pregnancy was implemented; it has now replaced surgical therapy in many cases. Thus, in less than 3 decades, management of ectopic pregnancy has evolved from emergency surgical treatment to conservative medical treatment. Indications Indications for surgical treatment of ectopic pregnancy include the following: The patient is not a suitable candidate for medical therapy. Medical therapy has failed. The patient has a heterotopic pregnancy with a viable intrauterine pregnancy. The patient is hemodynamically unstable and needs immediate treatment. Contraindications The only contraindications to surgical management are the following: The patient has a medically treatable ectopic pregnancy. The patient has other medical conditions that would make the risks associated with surgery unacceptable.