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

1. Administration of general anesthesia.
2. For abdominal approach: making a small incision in the abdomen (laparotomy) or several small incisions (laparoscopy) to insert surgical instruments.
3. For vaginal approach: accessing the reproductive organs through the vagina.
4. Locating the ectopic pregnancy.
5. Removing the affected fallopian tube (salpingectomy) and/or ovary (oophorectomy).
6. Inspecting the area for any additional complications or bleeding.
7. Closing the incisions with sutures or staples.
8. 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.