Assessment of the laparoscopic treatment of ectopic pregnancy

To assess the first 2 years experience of the laparoscopic surgical treatment of ectopic pregnancy in a regional referral centre.

All cases of ectopic pregnancy in a 2 year period from August 1991 were evaluated to assess the impact on the routine management of this condition.

In the first year 14 cases were managed by laparoscopic means and took an average operating time of mean 73.8 (SD 17.2) minutes compared to mean 69.1 (17.9) minutes in the 26 cases managed this way in the second year. The 40 patients were hospitalised for an average of 1.4 days and 24 stayed one night only. There was no difference in operating time between registrars and consultants. The only major complication was a patient who required an emergency laparotomy because of continued bleeding. When all cases of ectopic surgery were evaluated in the second year, six of the 32 cases required laparotomy to complete the operation.

The benefits of laparoscopic surgical treatment of ectopic pregnancy dictate that this should be employed as first line treatment for all cases of tubal ectopic gestation. Our experience suggests that achieving such a service, whilst not without pitfalls, should be possible in all gynaecology units provided that staff are motivated and that laparoscopic equipment is available.