AAGL 2013: Laparoscopy Is Feasible for Ruptured Ectopic Pregnancy, Massive Hemoperitoneum


Laparoscopy for ruptured ectopic pregnancy and massive intra-abdominal bleeding was associated with shorter operative time and less intraoperative blood loss than laparotomy.

Laparoscopy is feasible and safe in patients with ruptured ectopic pregnancy and massive hemoperitoneum, and the procedure is also associated with significantly shorter operative times compared with laparotomy, according to study findings presented last week at the 42nd AAGL Global Congress on Minimally Invasive Gynecology, held in National Harbor, Maryland.

The retrospective cohort study, which was conducted by researchers from Tel Aviv, Israel, was designed to establish whether the minimally invasive laparoscopic procedure was as safe and effective as the more invasive open abdominal surgery.

The findings of significance were a short operative time for the laparoscopic procedure (median time, 50 minutes vs 60 minutes for laparotomy; P = 0.01) and significantly less intraoperative blood loss for the laparoscopic group (1000 mL vs 1500 mL for the laparotomy group; P = 0.02).

The hemodynamic status of patients was similar between study groups, and there were no differences between the procedure groups in terms of need for blood products, perioperative complication rates, and hospitalization period (4 days for both groups).

Aviad Cohen, MD, from Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, and colleagues said that the reduced amount of hemoperitoneum in patients undergoing laparoscopy may be the result of shorter operative times and the ability to more quickly control hemorrhages with the minimally invasive intervention.


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