Laparoscopic management of ectopic pregnancy: a 5-year experience.

The objective of this study was to review our management of ectopic pregnancy with the introduction of a laparoscopic service to the obstetrics and gynaecology department at South Cleveland Hospital. A retrospective analysis of 210 cases of ectopic pregnancy managed from May 1995 to May 2000 including operative findings and surgical data were collected prospectively over the past 5 years. All our women with an ectopic pregnancy were treated surgically. One hundred and seventy-seven (84.3%) patients were managed successfully laparoscopically with no major intraoperative or postoperative complications. Thirty-three (15.7%) women were managed by laparotomy for various reasons. Salpingectomy was the main (80%) procedure performed either by laparoscopy or by laparotomy. Thirty-five (16.7%) women were treated conservatively by salpingostomy. Of these 22.9% achieved a successful pregnancy and delivery. Half of our patients were managed by senior registrars. The estimated blood loss, the need for blood transfusion and the length of hospital stay following laparoscopic treatment were significantly less than those in laparotomy group. This study demonstrated that laparoscopic management of ectopic pregnancy is the most beneficial procedure with maximum safety and efficiency when the laparoscopic service is added to the unit.