Surgery
At any stage of development, surgical removal
of an ectopic growth and/or the
fallopian tube section where it has implanted is the
fastest treatment for
ectopic pregnancy. Surgery may be your only treatment
option if an ectopic pregnancy has gone past 6 weeks or if you have internal
bleeding. Whenever possible, surgery is done through a small incision using
laparoscopy. This type of surgery usually has a short
recovery period.
Surgery Choices
An ectopic pregnancy can be removed from a fallopian tube
by using salpingostomy or salpingectomy.
- Salpingostomy. The ectopic growth is
removed through a small, lengthwise cut in the fallopian tube (linear
salpingostomy). The cut is left to close by itself or is stitched closed. This
surgery can be done when an embryo is smaller than
2 cm and is growing near the far end of the
fallopian tube.5
- Salpingectomy. A fallopian tube segment
is removed. The remaining healthy fallopian tube may be reconnected.
Salpingectomy is needed when the fallopian tube is being stretched by the
pregnancy and may rupture or when it has already ruptured or is very damaged.
Both salpingostomy and salpingectomy can be done either
through a small incision using
laparoscopy or through a larger open abdominal
incision (laparotomy). Laparoscopic surgery has few risks and
heals more quickly than laparotomy.5 But for an
abdominal ectopic pregnancy or an emergency tubal ectopic removal, a laparotomy
is usually required.
What To Think About
When an ectopic pregnancy is
located in an unruptured
fallopian tube, every attempt is made to remove the
pregnancy without removing or damaging the tube.
Emergency surgery
is needed for a
ruptured ectopic pregnancy.
Future fertility
Your future fertility and your
risk of having another ectopic pregnancy will be affected by your own
risk factors. These can include smoking, use of
assisted reproductive technology (ART) to get
pregnant, and how much fallopian tube damage you have.
As long
as you have one healthy fallopian tube, salpingostomy (small tubal slit) and
salpingectomy (part of a tube removed) have about the same effect on your
future fertility. But if your other tube is damaged, your doctor may try to do
a salpingostomy. This may improve your chances of getting pregnant in the
future.2