[Minimally invasive surgery in the treatment of extrauterine pregnancy].

Of 147 patients operated by endoscopy, 86 (59%) were treated conservatively by linear salpingotomy or tubal aspiration and 61 (41%) were treated by salpingectomy. One patient with a history of bilateral salpingectomy had a cornual implantation and was also successfully treated by laparoscopic technique. There were no intraoperative complications. In eight patients (4.5%) with postoperative complications, a second operation was performed because of persistent trophoblast and/or hemorrhage. Six patients were treated by laparoscopic salpingectomy. All complications were associated with conservative treatment and typically occurred with a delay of up to 23 days. In six of these instances, the surgeon was rather inexperienced in laparoscopic operation. After an average follow-up time of 22 months, the pregnancy rate was 68%, of which 73% were intrauterine pregnancies. Laparoscopic treatment of ectopic pregnancies has proven to be an effective and safe procedure even at a teaching hospital. Since all complications occurred after conservative treatment this data suggests that salpingectomy should be the treatment of choice in ectopic pregnancy, whereas linear salpingotomy should only be performed when specially indicated.