Laparoscopic cornuotomy using a temporary tourniquet suture and diluted vasopressin injection in interstitial pregnancy

Choi, Y.; Eun, D.; Choi, J.; Shin, K-S; Choi, J.; Park, Hyoung-Duck

doi:10.1016/j.fertnstert.2008.02.013

Cited by 42 publications

(23 citation statements)

References 14 publications

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“…Nevertheless, both the surgery and the postoperative period were uneventful for our patients. This is consistent with several recent reports describing the successful use of laparoscopic cornuotomy for similar cases . Thus, preoperative serum hCG levels and the presence of a fetal heartbeat may not accurately predict the success or failure of laparoscopic cornuotomy for interstitial pregnancy, although a larger sample size would be needed to confirm this point …”

Section: Discussionsupporting

confidence: 88%

“…Laparoscopic cornuotomy is an attractive alternative to laparoscopic cornual resection, because it preserves the normal uterine myometrium. Several recent reports have described the use of laparoscopic cornuotomy to treat interstitial pregnancy . However, there are few reports validating this treatment or documenting its effect on subsequent pregnancy outcomes, which is not surprising given the rarity of interstitial pregnancy .…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic cornuotomy for interstitial pregnancy and postoperative course

Watanabe

et al. 2014

J of Obstet and Gynaecol

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Laparoscopic cornuotomy for interstitial pregnancy and postoperative course

Watanabe

et al. 2014

J of Obstet and Gynaecol

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“…Factores de riesgo. El embarazo ectópico cornual tiene los mismos factores de riesgo que los otros tipos de embarazos ectópicos: enfermedad pélvica inflamatoria (EPI), embarazo por reproducción asistida, consumo de cigarrillos, cirugía pélvica previa, embarazo ectópico anterior y el antecedente de salpingectomía ipsilateral (13,19). En una serie de casos, Tulandi y Al-Jaroudi (20), en 32 pacientes encontraron que el factor más importante fue el daño de una trompa en embarazo ectópico previo (40,6%), salpingectomía ipsilateral o bilateral (37,5%), fertilización in vitro (34,4%), historia de enfermedad de transmisión sexual (25,0%), e inducción de ovulación (3,1%).…”

Section: Resultsunclassified

Embarazo ectópico cornual recurrente: caso clínico y revisión de la literatura

2015

Rev. chil. obstet. ginecol.

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Reportar un caso de embarazo ectópico cornual recurrente, al que se le realizó manejo por laparoscopia. Realizar una revisión de la literatura sobre este tema. Caso clínico: Se presenta el caso de una paciente de 34 años, con embarazo cornual recurrente a quien se le realizó manejo exitoso por laparoscopia. Método: Se realizó una búsqueda bibliográfica en las bases de datos con las palabras clave: pregnancy, intersticial y cornual ectopic en Medline, PubMed, Embase, Cochrane Data base, Ovid, Hinari, Scielo y Bireme. Resultados: La búsqueda inicial arrojó 311 artículos, de los cuales se seleccionaron 116 y posteriormente 74 artículos, que estaban relacionados con el tema a revisar, finalmente se escogieron 38 artículos con texto completo. Conclusión: El embarazo ectópico cornual o intersticial tienen los mismos factores de riesgo que el embarazo tubárico. El avance en ecografía y los niveles de βHCG han permitido un diagnóstico precoz, lo que permite realizar tratamientos médico o quirúrgico más conservadores, donde la laparoscopia ha empezado a tener un papel muy importante.

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“…The procedure usually starts with a salpingectomy and removing the cornual pregnancy using bipolar forceps and scissors. Usually hemostasis is achieved using electrocoagulation [3] but other techniques have been tested such as fibrin glue [4] , harmonic scalpel [5], cornuostomy after temporary tourniquet [6], selective ipsilateral uterine artery ligation [7] or combined laparoscopic and hysteroscopic approach [8]. Ostrzenski et al also described the effective use of a ligature applied through the broad ligament [9].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic-assisted instillation of epinephrine and levobupivacaine enables cornual excision and anatomical reconstruction in unruptured cornual pregnancy

Gilabert‐Estellés¹,

Gilabert-Aguilar²

2014

OJOG

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The objective of this report is to describe the possible use of intramiometrial vasoconstrictive agents for laparoscopic management of interstitial pregnancy and the consequences in anatomical results and reproductive outcomes. Cornual resection can be performed by laparoscopy, but the high vascularization of this area may result in profuse bleeding and laparoscopic suturing under these conditions might be impossible for the majority of the surgeons. We present a case that describes the possible use of intramiometrial instillation of a solution of diluted epinephrine and levobupivacaine under laparoscopic guidance that permitted a bloodless cornual excision with complete reconstruction. Vasoactive agents might have potentially serious cardiovascular side effects and the correct election of the active principle and the dosage is essential to reduce the risk of the surgery and obtain good anatomical results and reproductive outcomes. In conclusion, unruptured interstitial pregnancies can be managed successfully with intramyometrial instillation of epinephrine and bupivacaine. This simple technique is particularly attractive as it facilitates anatomical reconstruction of the cornual area, gives enough time to perform a complete suture of the defect and reduces the risk of laparotomic conversion.

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Laparoscopic cornuotomy using a temporary tourniquet suture and diluted vasopressin injection in interstitial pregnancy

Cited by 42 publications

References 14 publications

Laparoscopic cornuotomy for interstitial pregnancy and postoperative course

Laparoscopic cornuotomy for interstitial pregnancy and postoperative course

Embarazo ectópico cornual recurrente: caso clínico y revisión de la literatura

Laparoscopic-assisted instillation of epinephrine and levobupivacaine enables cornual excision and anatomical reconstruction in unruptured cornual pregnancy

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