Ectopic pregnancy - surgical treatment

Here we will explain the various operative procedures that are used to treat an ectopic pregnancy. We will discuss your preferences with you before your operation including your desire for future pregnancies if appropriate.

Laparoscopy (keyhole surgery)

The operation is performed under general anaesthetic. The anaesthetist will see you before your operation.

This involves the surgeon making two or three small incisions in your abdomen.

One at the umbilicus (navel) and one or two lower down near the bikini line. A small amount of gas is introduced into your abdominal cavity to inflate it, so as to allow the surgeon to see the structures inside your abdomen and the ectopic pregnancy through the laparoscope. (A laparoscope is a small telescope like instrument). If an ectopic pregnancy is confirmed, the surgical procedure undertaken depends on the condition of your fallopian tube.

On the other hand, if the tube is ruptured or distorted it may be necessary to remove part or all of the tube according to the degree of damage. This is called a salpingectomy (partial or complete). However, your other tube will remain along with your ovaries. Your surgeon will decide whether to perform your operation under laparoscopy or proceed to a laparotomy.

Before rupture of your tube it may be possible to make a cut on the tube and remove the pregnancy leaving the tube intact. This is called salpingotomy.

There is only a small risk of injury to the bowel, bladder and blood vessels with the laparoscope (1/1000).

Laparotomy

A cut about eight to ten centimetres long is made usually along the bikini line to enter inside the abdomen. This procedure is chosen if the laparoscopic procedure is unsuccessful or impossible.

Your hospital stay

This will vary depending on the operation you need. It is normal one to two days after laparoscopy and two to three days after laparotomy.

After discharge

Normally the stitches are dissolvable, you will be advised if otherwise. You may experience period like bleeding for a week or two, avoid using tampons during this time. You should also avoid sexual intercourse until the bleeding has stopped.

Returning to work

It may be anytime from one to six weeks depending on the type of operation you have had and the type of work you do. Your doctor will advise you.

Your feelings

It is entirely normal to feel helpless, isolated and angry with yourself. Depression, guilt and self-blame are very common emotions after the loss of a baby. With an ectopic pregnancy you will not only lose your pregnancy but will also be recovering from an operation and may have worries about fertility for the future. As time passes you will be able to deal with your loss more positively. If your anxiety and worries continue, you should get in touch with your GP who will be able to help you. Your wellbeing is the most important thing.

Your partner may find it difficult to express his feelings. He may well feel that he should be strong and protect you from any more distress. If this is the case, he may need encouragement to talk about his feelings. Sharing each others feelings can be very helpful.

Allow yourself time to recover physically and emotionally before trying for another baby. It is worth remembering that counselling is available for you if you need to talk at any time in the future.

If you need any further information or advice, please do not hesitate to ask the staff.

In your next pregnancy

The recurrent ectopic rate is about 10-20 per cent. After Salpingotomy, ectopic pregnancy is equally likely to reoccur in the operated tube as in the other tube.

When you suspect you might be pregnant again your GP will be able to refer you to the Early Pregnancy Assessment Clinic after confirmation of the pregnancy. You will be monitored closely because of the previous ectopic pregnancy.

Ref: 14-21-181
Review: 09/23