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Interstitial Ectopic Pregnancy: Laparoscopic Cornuostomy.

Mohamed Elsherbiny1, Ee Thong Lim1, Kenneth Ma2

  • 1Manchester Foundation Trust, Manchester, United Kingdom (all authors).

Journal of Minimally Invasive Gynecology
|March 4, 2023
PubMed
Summary

This study demonstrates cornuostomy, a conservative surgical technique for managing interstitial ectopic pregnancy. This approach minimizes uterine damage and preserves future fertility in women with this rare but dangerous condition.

Keywords:
CornuectomyCornuostomyEctopicEctopic pregnancyInterstitial ectopic pregnancyInterstitial pregnancyLaparoscopy

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Area of Science:

  • Reproductive Medicine
  • Minimally Invasive Surgery
  • Gynecologic Oncology

Background:

  • Interstitial ectopic pregnancy is rare but carries a high mortality rate.
  • It often presents late, mimicking intrauterine pregnancy, and can lead to catastrophic bleeding.
  • Surgical options include cornual resection or cornuostomy, with cornuostomy offering a more conservative approach.

Purpose of the Study:

  • To demonstrate and discuss the technique of cornuostomy for surgical management of interstitial ectopic pregnancy.
  • To highlight cornuostomy as a conservative surgical option.
  • To provide a stepwise video demonstration of the procedure.

Main Methods:

  • Laparoscopic cornuostomy performed on a 22-year-old woman at 7 weeks gestation.
  • Vasopressin injection at the ectopic pregnancy base, followed by monopolar diathermy incision and hydrodissection.
  • Defect closure in two layers.

Main Results:

  • Successful laparoscopic cornuostomy was performed.
  • The procedure involved vasopressin injection, diathermy incision, and hydrodissection.
  • Total operating time was 46 minutes.

Conclusions:

  • Cornuostomy is a viable, conservative surgical option for interstitial ectopic pregnancy.
  • An individualized approach is essential, considering patient history and fertility desires.
  • Laparoscopic cornuostomy was deemed the best option for this patient due to her history and wishes.