Treatment of bilateral tubal pregnancy is controversial and it ranges from bilateral salpingectomy to the conservative approach such as salpingostomy and salpingotomy
Current labeling recommends salpingotomy
or salpingectomy as first-line options for removal, and after a request from the FDA, Bayer is updating Essure's label to give more information on how to use those procedures to remove the device.
There are three surgical approaches for ectopic pregnancy: salpingotomy
, salpingostomy and radical salpingectomy.
Other predisposing conditions include septic abortion, hysterectomy, mini laprotomy for bilateral salpingotomy
, episiotomy and caesarean section, abdominal and perineal infections.
This involves a salpingectomy if the contralateral tube is healthy or a salpingotomy
when this is not the case.
Twenty-five (n = 15) patients complained of lower abdominal pain between days 2-7 and out of them 25% (n = 12) required early surgical intervention by diagnostic laparoscopy followed by salpingectomy or salpingotomy
by open laparotomy.
Where possible a salpingotomy
is performed avoiding salpingectomy and possible reduction of fertility (RCOG 2004).
Bilateral tubal pregnancy and laparoscopic bilateral salpingotomy
Conservative surgical methods include tubal milking and salpingotomy
There are several options for surgery, including laparoscopic cornual resection, cornuostomy, or salpingotomy
An ectopic pregnancy with normal vasculature might be managed medically with methotrexate or managed surgically with salpingotomy
, said Dr.
Laparoscopic approach for cornual resection or salpingotomy
via myometrium has been reported.