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This presentation of one of the larger series of patients with cornual ectopic pregnancy managed by laparoscopic surgery reveals that experience at ultrasonography and laparoscopic technique can lead to earlier diagnosis and few cases requiring laparotomy or further treatment. In addition laparoscopic surgery for cornual ectopic is safe and lends itself to conservative approach (cornuostomy) in selected cases.

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This case demonstrates that laparoscopy is a feasible approach and can provide rapid diagnosis and control of bleeding in such cases provided there is availability of efficient multi-disciplinary teamwork, optimal anesthesia, advanced cardiovascular monitoring, laparoscopic expertise and ability to convert rapidly to laparotomy if required.

Background/Aims: Operative laparoscopy (OL) is considered the gold standard surgical treatment of ectopic pregnancy (EP). We questioned whether a training programme to foster OL treatment is able to ensure that all women needing surgical management are treated by OL irrespective of the site of EP, haemodynamic status and clinical complexity. Methods: A 13-year cohort study of 963 women who underwent surgical management was conducted. We instituted a ‘universal OL' programme in 2003 for the management of all the types of EP irrespective of the haemodynamic status. Results: There were 802 women in the prospective (2003-2013) and 161 in the retrospective arm (2000-2002). The rate of OL before 2003 was 34%. During the year of programme implementation, the OL rate rose from 89% in 2003 to 96% in 2004. It took 4 years to achieve a 100% OL rate in haemodynamically stable patients. In 2013, we were able to achieve OL treatment for all patients irrespective of haemodynamic status, the complexity of surgery or the location of EP. Conclusion: Our study demonstrates that a dedicated team with special training in minimal invasive surgery can improve surgical management of all categories of EPs, and this goal should be achievable across most units.