Surgical treatment of ectopic pregnancy

The treatment principle for patients with ectopic pregnancy is mainly surgical treatment. There are two surgical methods: salpingectomy and surgery to preserve the affected fallopian tube, that is, conservative surgery.

Salpingectomy

Generally, salpingectomy should be performed after the diagnosis of ectopic pregnancy. If sterilization is required, the contralateral fallopian tube can be ligated at the same time. The surgical procedure is selected according to the patient's general condition, the implantation site of the fertilized egg, and the degree of tubal lesions. For example, in case of fimbria pregnancy, fertilized egg expression is performed; in case of ampulla pregnancy, incision is performed to remove the fertilized egg; in case of isthmus pregnancy, lesion resection and stump anastomosis can be performed. The use of microsurgical techniques can improve the pregnancy rate. For the treatment of interstitial tubal pregnancy, the affected uterine horn resection or total hysterectomy can be performed according to the lesion.

Conservative surgery

Young women who want to have children can undergo conservative surgery to preserve the fallopian tube and its function if the contralateral fallopian tube has been removed or has obvious lesions. In recent years, due to the improvement of diagnostic technology, more and more tubal pregnancies have been diagnosed before miscarriage or rupture, so the use of conservative surgery has increased significantly compared with the past. The surgical procedure is selected according to the implantation site of the fertilized egg and the condition of the fallopian tube lesions. If it is an infundibulum pregnancy, the pregnancy products can be squeezed out; if it is an ampulla pregnancy, the fallopian tube is opened to remove the embryo and then sutured; if it is an isthmus pregnancy, the diseased segment is resected and end-to-end anastomosis is performed. If microsurgery is used in the operation, the subsequent pregnancy rate can be improved. In addition to laparotomy, conservative surgery can also be performed through laparoscopy.