[Introduction of laparoscopic surgery in extrauterine pregnancy]

Top evaluate laparoscopic surgery in extrauterine pregnancy, the period from 1990-1993 was analysed, and the first 44 operations including only one laparoscopy (2%), were compared with the following 70 operations with 60 laparoscopic procedures (86%). Except for a younger mean gestational age in the second interval, both groups showed no differences in the history and preoperative findings. During the second period, however, the intraoperative blood loss was smaller and the rate of conservative procedures was higher. Operation times and complication rates were not different. But in laparoscopy, duration of the procedure significantly decreased with advancing experience. Postoperative hospital stay was half as long in the second group. Subsequent procedures were necessary in 3% of 61 laparoscopies due to adhesion ileus and persistent trophoblast, respectively. Persistent pregnancy was seen in 2% of 42 conservative laparoscopies. Laparotomy due to failed laparoscopy was done in 2 of 63 patients (3%) with bleeding complications. Laparoscopy in the hand of the experienced surgeon is a suitable method to treat ectopic pregnancy and allows also organ preservation.