Surgical treatment of ectopic pregnancy; tubal or ovarian, requiring salpingectomy and/or oophorectomy, abdominal or vaginal approach
CPT4 code
Name of the Procedure:
Surgical treatment of ectopic pregnancy; tubal or ovarian, requiring salpingectomy and/or oophorectomy, abdominal or vaginal approach
Common Names: Ectopic Pregnancy Surgery, Tubal Removal, Ovarian Removal
Medical Terms: Salpingectomy (removal of a fallopian tube), Oophorectomy (removal of an ovary)
Summary
This surgical procedure treats an ectopic pregnancy, which occurs when a fertilized egg implants outside the uterus, commonly in the fallopian tube or ovary. The surgery involves the removal of the affected fallopian tube (salpingectomy) and/or ovary (oophorectomy) via an abdominal or vaginal approach.
Purpose
This procedure addresses ectopic pregnancies, which can be life-threatening if not treated. The goal is to safely remove the ectopic tissue to preserve the health of the patient and to prevent complications such as internal bleeding.
Indications
- Diagnosed ectopic pregnancy
- Severe abdominal pain
- Internal bleeding
- Presence of pelvic mass
- No response to medical management or contraindications to medical therapy
Preparation
- Fasting for 8-12 hours prior to surgery
- Adjustment of current medications as advised by the doctor
- Blood tests, ultrasound, or other imaging tests to confirm the diagnosis and location of the ectopic pregnancy
- Pre-anesthesia evaluation
Procedure Description
- Administration of general anesthesia.
- For abdominal approach: making a small incision in the abdomen (laparotomy) or several small incisions (laparoscopy) to insert surgical instruments.
- For vaginal approach: accessing the reproductive organs through the vagina.
- Locating the ectopic pregnancy.
- Removing the affected fallopian tube (salpingectomy) and/or ovary (oophorectomy).
- Inspecting the area for any additional complications or bleeding.
- Closing the incisions with sutures or staples.
- Patient recovery under close monitoring.
Duration
Typically, the procedure lasts between 1-2 hours.
Setting
Usually performed in a hospital or surgical center.
Personnel
- Surgeon (usually a gynecologist)
- Anesthesiologist
- Surgical nurses
- Operating room technicians
Risks and Complications
- Infection
- Bleeding
- Damage to surrounding organs
- Adverse reaction to anesthesia
- Blood clots
- Future fertility issues
- Rare risks: severe allergic reactions, need for further surgery
Benefits
- Resolves the life-threatening condition of an ectopic pregnancy
- Stops internal bleeding and hemorrhage
- Immediate pain relief from ruptured ectopic pregnancy
- Preserves the health of the patient
Recovery
- Hospital stay for 1-2 days if laparoscopic, longer if a more extensive surgery is required.
- Avoid heavy lifting and strenuous activities for several weeks.
- Pain management with prescribed medications.
- Follow-up appointments for monitoring recovery and ensuring no complications.
- Watch for signs of infection (fever, redness at incision site).
Alternatives
- Medical treatment with methotrexate for unruptured ectopic pregnancies.
- Expectant management if the risk is low and the pregnancy is very early.
- Pros: less invasive options. Cons: may not be suitable for all, longer follow-up, and potential for failure requiring surgery.
Patient Experience
- Patients will feel drowsy or groggy post-procedure due to anesthesia.
- Mild to moderate pain managed with painkillers.
- Some discomfort around the incision site.
- Feeling of emotional distress common due to the nature of ectopic pregnancy.
- Supportive care and counseling may be beneficial.