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Fallopian Tubes
and Ovaries

Laparoscopy Technique

Diagnostic Uses
of Laparoscopy

Demonstration
of Tubal Patency
via Laparoscopy

Laparoscopic Resection of Unruptured
Ectopic Pregnancy

Ovarian Biopsy
via Laparoscopy

Electrocoagulation of
Endometriosis via
Laparoscopy

Lysis or Adhesions
via Laparoscopy

Control of Hemorrhage
During Laparoscopy

Fallopian Tube
Sterilization

Sterilization by
Electrocoagulation and
Division via Laparoscopy

Silastic Band Sterilization
via Laparoscopy

Hulka Clip Sterilization
via Laparoscopy

Sterilization by the
Pomeroy Operation

Sterilization by the
Modified Irving Technique

Sterilization by the
Minilaparotomy Technique

Sterilization - Ucheda Technique

Salpingectomy

Salpingo-oophorectomy

Fimbrioplasy

Tuboplasty -
Microresection
and Anastomosis
of the Fallopian Tube

Wedge Resection
of the Ovary

Torsion of the Ovary

Ovarian Cystectomy

Laparoscopic Resection of
Unruptured Ectopic Pregnancy

The laparoscopic resection of unruptured ectopic pregnancy has become a useful and efficacious management of this problem that formally required a pelvic laparotomy with a lengthy hospital stay. These patients usually presented with the triad of amenorrhea, pelvic pain and vaginal bleeding.

The laparoscope can be an additional diagnostic aid as well as a surgical treatment.

Physiologic Changes.  The oocyte site has been impregnated with sperm, usually in the midportion of the Fallopian tube. There are some physiologic factors present that do not allow the new embryo to be taken down the tube and into the endometrial cavity. These frequently range from a history of inflammatory disease to external adhesions that obstruct the Fallopian tube.

Removal of the trophoblastic tissue from the tube immediately lowers the human chorionic gonadotropin levels in the blood. 

Points of Caution. Laparoscopy may be difficult in patients with a large ruptured ectopic pregnancy with copious bleeding. In these patients, laparoscopy is a waste of time. These patients should be treated with laparotomy.

In certain cases, the surgeon may find that the serum chorionic gonadotropin levels have not fallen after laparoscopy. This may mean that all trophoblastic tissue has not been resected. If the patient is stable, treatment with methotrexate may be indicated.

Technique