Abstract
Objectives: We used endoloops in the laparoscopic managements of interstitial pregnancy to investigate its usefulness.
Methods: Five cases of interstitial pregnancy (including 1 case of heterotopic interstitial pregnancy) were managed laparoscopically using the modified endoloop method as previously reported by Moon. Patient background, preoperative blood human chorionic gonadotropin (hCG) level, operation time, amount of blood loss and changes of postoperative hCG level were retrospectively reviewed. When interstitial pregnancy was identified, the fallopian tube and utero-ovarian ligament were cut after bipolar coagulation in the region proximal to the interstitial pregnancy. Then the cornual region was fastened by an endoloop to induce ischemia. Diluted vasopressin was injected into the cornual region, where further ligation was performed with the second endoloop, and the cornual region was incised. The second endoloop was gradually tightened simultaneously with the complete evacuation of the conceptus.
Results: Amount of blood loss was 350ml in one case and was not remarkable in other 4 cases. Operation time was 55-118 minutes. The mass size was 22-40mm. Preoperative blood hCG level was 11,000-20,100IU/l (except one case of heterotopic pregnancy). No case required an additional treatment for persistent ectopic pregnancy, but only one case showed the favorable decrease in postoperative hCG level.
Conclusion: Laparoscopic surgery for interstitial pregnancy using an endoloop was safe and bloodless. However, decrease of postoperative hCG level was not sufficient in many cases.
