Transvaginal Natural Orifice Transluminal Endoscopic Surgery for Tubal Stump Pregnancy
| Autor: | Arif Onur Atay, Ismail Mete Itil, Gokay Ozceltik, Ahmet Özgür Yeniel |
|---|---|
| Přispěvatelé: | Ege Üniversitesi |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Natural Orifice Endoscopic Surgery Pessary medicine.medical_specialty animal structures Ectopic pregnancy medicine.medical_treatment Colpotomy Salpingectomy 03 medical and health sciences 0302 clinical medicine Port (medical) Blunt dissection Pregnancy Minimally invasive surgery Laparotomy medicine Humans Laparoscopy 030219 obstetrics & reproductive medicine medicine.diagnostic_test business.industry NOTES Obstetrics and Gynecology Tubal stump pregnancy Natural orifice transluminal endoscopic surgery medicine.disease Surgery 030220 oncology & carcinogenesis Vagina Female Pregnancy Tubal business |
| Popis: | Objective To demonstrate a case of left tubal stump pregnancy successfully treated using our 2-step technique for transvaginal natural orifice transluminal endoscopic surgery (vNOTES). Design Demonstration of the technique using surgical video footage. Setting Tertiary university hospital. Interventions A 27-year-old gravida 3 para 0 patient with a history of laparotomy, left salpingectomy owing to a ruptured tubal pregnancy, was referred to our hospital because of a pregnancy of unknown location. Her serum β human chorionic gonadotropin level was 8400 U/L, and a transvaginal ultrasound revealed an ectopic pregnancy in the left tubal stump. After discussing medical and surgical treatment options, the patient underwent a 2-step vNOTES approach. First, a diagnostic vNOTES was performed using a 5-mm trocar with autoretracting blade. After confirmation of the diagnosis, the trocar was removed, and the incision was enlarged with blunt dissection. A self-constructed pessary port was then placed through the enlarged colpotomy, and the ectopic pregnancy in the left tubal stump was excised using an advanced bipolar device. The colpotomy was closed with running resorbable sutures. The duration of the surgery was 36 minutes, and the patient was discharged on postoperative day 1 without any complications. Conclusion Tubal stump pregnancy is a rare form of ectopic pregnancy with an incidence of approximately 0.4% of all ectopic pregnancies [1] . Treatment options include conservative medical management using methotrexate and surgery. Successful surgical treatment using laparoscopy has been previously reported [ 1 , 2 ]. This case demonstrates that vNOTES may be a minimally invasive option for the surgical treatment of tubal stump pregnancy in selected cases. |
| Databáze: | OpenAIRE |
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