Table 2: Laparoscopic management of interstitial or cornual ectopic pregnancy with stapler (Endo GIA™, Echelon Flex™ Endopath®) in published cases.
| References | Cases (n) | Parity | Gestational age (weeks) | Pre-operative ß-hCG (mIU/mL) | Size (mm) | Side | Cardiac activity | Rupture | Hemo-peritoneum | Surgical technique | EBL (mL) | Note | Follow-up |
| Sergent, et al. [9] | 3 | NA | 6 | 20,114 | 30 × 50 | NA | NA | ✓ | ✓ | Salpingectomy Cornual resection | NA | Average operative time: 30 minutes Patient 3 received IV iron to compensate for blood loss |
ß-hCG levels declined in all patients Fertility not assessed (loss of follow-up or no desire for future fertility) |
| NA | 7 | 1,508 | 15 × 20 | NA | NA | ✓ | ✓ | Salpingectomy Cornual resection | NA | ||||
| NA | NA | 3,095 | 20 × 20 | NA | NA | ✓ | ✓ Massive | Salpingectomy Cornual resection | 2000 | ||||
| Ravi, et al. [10] | 3 | Multipara | 7 | 14,100 | 60 | Right | ✓ | ✘ | ✘ | Cornual resection | 250 | Operative time: 155, 160, and 120 minutes respectively Hemostatic techniques: endoclips, sutures, cautery, and Surgicel™ |
Followed for 6 weeks, 3, and 3 months respectively
ß-hCG levels declined in all patients and menses resumed |
| Grand multipara (Previous tubal pregnancy) | 6 | 31,200 | 50 | Left | ✓ | ✘ | ✘ | Cornual resection | 200 | ||||
| Multipara | 7 | 17,900 | 30 | Right | ✓ | ✘ | ✘ | Cornual resection | 50 | ||||
| Lodhi, et al. [11] | 3 | NA | 7 | 6,041 | 40 | Left | NA | ✓ | ✓ | Cornual resection | 750 | Followed for 6 months and were doing well with normal menses | |
| NA (Previous ectopic pregnancy) | 6 | NA (Positive urine test) | 50 | Left | NA | ✓ | ✓ Massive | Cornual resection | 3500 | Presented with hypovolemic shock, operated as an emergency case using two staplers
Required blood transfusion |
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| NA | 8 | 35,064 | 50 | Left | NA | ✓ | ✓ | Cornual resection | 1000 | Initial ß-hCG level was 19,714, underwent medical treatment with MTX but ß-hCG level continued to rise | Lost to follow-up | ||
| Akhtar, et al. [12] | 1 | G5 P2 | 7 (Twin) | 16,740 | 25 | Left | ✓ | ✘ | ✘ | Salpingectomy Cornual resection | 100 | Echelon Flex™ Endopath™ stapler was used
Operative time: 25 minutes |
ß-hCG level declined to the pre-pregnancy level in 3 weeks |
| Our case | 1 | G2 P1 | 7 | 6,111 | 27 × 17 | Left | ✓ | ✘ | ✘ | Salpingectomy Cornual resection | 50 | Operative time: 60 minutes | Followed for 3 months, ß-hCG level declined and menses resumed |