Laparoendoscopic single site surgery for interstitial pregnancy: a surgical education video

Interstitial pregnancy (IP) of fallopian tube is a rare type of tubal pregnancy; the location of implantation is at the proximal fallopian tube passing through the myometrium. IP used to be treated with medications or traditional surgical methods such as laparoscopic cornual resection and cornuostomy. However, cornual resection may cause significant damage to the myometrium, while cornuostomy carries a risk of persistent ectopic pregnancy. Laparoendoscopic single-site surgery (LESS) is a minimally invasive technique that can address these issues while offering enhanced cosmetic results and reduced postoperative pain. In this case, purse-string suture technique for removing the lesion of the affected fallopian tube by LESS was performed, which simultaneously takes the minimally invasive surgery and the protection of the uterine muscle tissue both into account. This video displays the procedures of resecting IP of the fallopian tube after purse-string suture around the lesion. The operation was carried out through a 2-cm incision at the umbilicus. The right fallopian tube with the lesion was resected after purse-string suture. The surgery lasted 70 minutes with 20-mL blood loss. After operation, the patient recovered well, and β-human chorionic gonadotrophin (β-hCG) levels were monitored until negative. The use of barbed absorbable surgical sutures simplified the procedure and facilitated hemostasis. LESS for IP is a minimally invasive approach with satisfactory therapeutic effects, using a 2-cm umbilical incision to achieve intra-abdominal surgery can fully alleviate postoperative pain, reduce the use of sedative drugs, and achieve a satisfactory cosmetic effect. But it requires surgeons to be proficient in relevant techniques and familiar with anatomical structures. IP is often difficult to diagnose early, and various diagnostic methods and treatment options are also discussed in this paper.