Ectopic Pregnancy - Surgery

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.⁸
• 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.⁸ 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 combination of 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.³