Minimally Invasive Surgery
Removal of Ectopic Pregnancy
As explained in the Common Problems Section, most ectopic pregnancies grow inside the Fallopian tubes. There are two options for treatment:
Medical treatment is done through an injection of Methotrexate, a drug that is usually used for chemotherapy. The drug destroys growing tissue, including the embryonic tissue growing inside the tube. The treatment usually includes a single intramuscular injection and is very well tolerated with minimal if any side-effects. It is seen as a more conservative and less invasive treatment as it does not require surgery for removal of the Fallopian tube.
The decision to give medical treatment is made on a case by case basis, but, in general terms, a woman is eligible for medical treatment if:
- The ectopic pregnancy has not ruptured and there is no blood inside the pelvis.
- The ectopic pregnancy is less than 3 cm in diameter as seen by the ultrasound.
- The blood levels of beta-HCG, the pregnancy hormone, are less than 3000.
When surgical treatment is required, virtually all ectopic pregnancies can be removed laparoscopically and open surgery is very rarely required. Most times the removal of the whole tube (salpingectomy) is required. In selected cases, it may be possible to do a salpingostomy which consists of making an incision on the tube and removing only the pregnancy thus preserving the tube.