Single-Incision Laparoscopic Surgery: Excision of Cornual Ectopic Pregnancy Made Simple Using ENDOLOOP

Abstract

Abstract

Background: Cornual or interstitial pregnancy is a rare subtype of ectopic pregnancy in which diagnosis may be elusive and treatment challenging. The laparoscopic approach has been used for treating this kind of pregnancy surgically whenever possible. However, reports on single-incision laparoscopic surgery (SILS) for treating cornual ectopic pregnancy are extremely sparse. This article describes a simplified SILS approach for treating a cornual ectopic pregnancy, using two ENDOLOOP^® ligatures. With this technique, surgeons could find it easier to adopt SILS for treating cornual ectopic pregnancy. Case: A 27-year-old Chinese female presented with a spontaneous right cornual ectopic pregnancy of 8 weeks' gestation. She was in stable condition with a preoperative serum β–human chorionic gonadotropin (β-hCG) level of 16,673 IU/L. Single-incision laparoscopic excision of the pregnancy, using 2 ENDOLOOP ligatures, was performed. Her serial serum β-hCG levels were monitored. Results: The cornual ectopic pregnancy was removed successfully. No conversion to conventional laparoscopy or laparotomy was needed. No perioperative surgical complications occurred. Operating time was 67 minutes. The patient recovered well postoperatively and serial β-hCG tests showed rapid resolution of her ectopic pregnancy. Conclusions: SILS for excision is safe and feasible for addressing cornual ectopic pregnancy in selected patients. The technique can be simplified by the use of two ENDOLOOP ligatures, therefore improving patient hemostasis, resulting in shorter operative time. Larger clinical studies using this approach will ascertain the feasibility and advantages of this technique further. (J GYNECOL SURG 33:17)