Use of an endolaparoscopic probe in conservative management of Fallopian pregnancy

The incidence of extrauterine pregnancy has shown an increasing trend, exceeding one out of every 100 term pregnancies. This has resulted in the development of more and more conservative surgical treatments in order to retain the fertility of women. The use of operative laparoscopy has led to progress being made in this direction, due to reduced tissue trauma and a reduction in the number of peritoneal adhesions. Tubal isthmic pregnancies tend to cause an irregular increase in the size of the whole tube, which causes problems for pinpointing the exact site of the ectopic implantation. It is often necessary to make a longitudinal incision in the tubal wall to identify the chorionic tissue and remove it completely. In an attempt to avoid this unnecessarily extensive surgery, we used an echographic sector probe under laparoscopic control to locate the exact area of the ectopic implantation. We found it was possible to remove the villous tissue through a very short and precise cut in the tubal wall which facilitated the drainage of the lumen and reduced the bleeding normally associated with more extensive tubal surgery. Hysterosalpingographic follow-up studies after 2 months showed good tubal recanalization.