Risk factors for conversion to laparotomy during laparoscopic management of an ectopic pregnancy

Abstract

Less experienced surgeon, BMI > 30 kg/m2, and large amount of free fluid on ultrasound increase the risk of conversion to laparotomy during laparoscopic management of ectopic pregnancy.

Evaluation of laparoscopic management of gynecologic emergencies by residents

“…Based on these measures, our results compare favorably with previous reports of laparoscopy in ectopic pregnancy [2,6,11], adnexal torsion [12][13][14], hemorrhagic ovarian cyst [15], and PID ± TOA [16], even when these procedures were performed by experienced surgeons.…”

“…Although the associated factors that modify these parameters after elective laparoscopic gynecologic procedures have been studied previously [1,8], little is known about gynecologic emergencies [6]. At the time of the present study, no investigation had specifically addressed these associated factors across the entire spectrum of laparoscopic treatment of gynecologic emergencies.…”

“…A well-structured laparoscopic training program during residency is critical for improving surgical skills [4] and patient outcomes [5]. Some reports have addressed the feasibility of laparoscopic management of gynecologic emergencies within a residency program, but have been focused on ectopic pregnancy [6]. Therefore, a complete assessment of laparoscopic management for the entire spectrum of gynecologic emergencies is needed [2].…”

Face and Construct Validity of the SimSurgery SEP VR Simulator for Salpingectomy in Case of Ectopic Pregnancy

“…Far fewer complications occur during laparoscopy when the procedure is performed by an experienced surgeon, in comparison to when the procedure is performed by a novice surgeon. [5][6][7] Tackacs et al found that surgeon inexperience was significantly associated with unintended laparotomy during laparoscopic management of an ectopic pregnancy. 7 Compared to open procedures, laparoscopy is more technically demanding and less efficient due to reduced dexterity, impaired vision, and tactile feedback.…”

“…[5][6][7] Tackacs et al found that surgeon inexperience was significantly associated with unintended laparotomy during laparoscopic management of an ectopic pregnancy. 7 Compared to open procedures, laparoscopy is more technically demanding and less efficient due to reduced dexterity, impaired vision, and tactile feedback. 8,9 The learning curve to reach the desired level of proficiency in laparoscopic skills is extensive.…”