OPERATIVE LAPAROSCOPY FOR ECTOPIC PREGNANCY - HOW EXPERIENCED SHOULD THE SURGEON BE

The purpose of this study was to assess the efficacy of laparoscopic s urgery for ectopic pregnancy in a general hospital in Paris, where mos t of the surgeons are still in training. During a period of 20 months, 100 cases of ectopic pregnancy were diagnosed and treated by the atte nding residents. Nine cases required a laparotomy due to heavy bleedin g or interstitial ectopic pregnancy. Most of the other cases were trea ted laparoscopically, with either salpingectomy (70 cases) or linear s alpingostomy (19 cases). Complications of the laparoscopic surgical pr ocedures were rare. There was one failure of linear salpingostomy that required a second intervention (5.3% failure rate); there was one cas e of urinary retention that resolved after 48 h; and one case of fever above 38-degrees-C that responded well to antimicrobial therapy. In c onclusion, we have shown that the current notion that laparoscopic sur gery is preferred to conventional abdominal surgery for the treatment of ectopic pregnancy, can be applied to a public gynaecological centre with young inexperienced residents, supervised by experienced gynaeco logists.