Ectopic Pregnancy Surgery
If your doctor believes you have an ectopic pregnancy that is not treatable with medication, surgery will be recommended. There are two types of surgery for ectopic pregnancy: laparoscopy and laparotomy. Both types can diagnose and treat the condition.
In some types of early ectopic pregnancies, a nonsurgical treatment can be used. This method generally consists of an injection of methotrexate. However, if your condition is not treatable with methotrexate, surgery will be necessary.
Two types of surgeries are used to treat an ectopic pregnancy. The most common form is a laparoscopy. A laparotomy (open abdominal surgery) is less common.
Laparoscopy can be used as a tool for diagnosing and treating some medical conditions, such as ectopic pregnancy, by actually looking inside your abdomen (stomach). This technique offers women many advantages over traditional ectopic pregnancy surgery. With laparoscopy, women usually have shorter hospital stays and quicker recovery times because it is a simpler, less invasive procedure.
The laparoscopy for an ectopic pregnancy is usually performed on an outpatient basis, meaning that you go home the day of your surgery. You will be given specific instructions as to:
- Where and when to arrive at the medical facility
- How to prepare for the surgery
- What to expect on the day of and in the days following the procedure.
You will be asked not to eat or drink anything for at least eight hours before your procedure. Your doctor may make additional dietary restrictions. Due to medications often used during an ectopic pregnancy surgery, you will not be able to drive for at least 24 hours afterward, so be sure to arrange for someone to drive you home.
Once you are in the operating room, you will be given anesthesia. After the anesthesia takes effect, your doctor will begin the laparoscopy. A small incision, or cut, will be made in or just below your navel. A tube, called a trocar, will then be inserted into your abdomen. Through the trocar, your doctor will fill your abdomen with carbon dioxide gas, which is like the air you breathe out. This gas makes it easier to see your pelvic structures clearly. The laparoscope will then be inserted.
Through the laparoscope, your doctor will view the inside of your abdomen on a video screen. The laparoscope can also take pictures and videotape the procedure. Your doctor will be looking for anything that appears abnormal.
If an ectopic pregnancy is found, your doctor will remove it. Since it is often necessary to use several instruments at this time, two or three additional small incisions will be needed. These incisions are made in the lower abdomen; they are often smaller than the incision in your navel. The method your doctor uses to remove the ectopic pregnancy will depend on:
- Its location
- If it has already ruptured
- Your desires for future childbearing
- Your current health.
For example, if the ectopic pregnancy is in a fallopian tube, your doctor may either open the tube and remove the pregnancy, or remove the whole tube. You would still be able to have children if this occurs, as long as your other ovary and tube are normal.
Once the surgery for ectopic pregnancy is complete, the instruments are removed and the gas released. The incisions are then closed with stitches and covered with a bandage. Your body will absorb these stitches over time, usually in about two to four weeks.