laparoscopic image of a salpingotomy
Salpingectomy or salpingotomy for the surgical treatment of ectopic pregnancy.
salpingectomy means removal of the fallopian tube
salpingotomy means opening up the tube whilst preserving it. the ectopic is removed and the tube is saved.
Before the mid 1950s most women (more than 80%) who had ectopic pregnancy would present once the pregnancy had ruptured, they would have internal bleeding and need a laparotomy (open surgery) to treat the ectopic pregnancy and this would mean removal of the affected tube.
Today most women are diagnosed with ectopic pregnancy before it ruptures; this is because of the availability of high-resolution ultrasound and the assay of human chorionic gonadotrophin bHCG that allows doctors to monitor the progression of an ectopic pregnancy.
To a reasonable extent doctors will take certain issues into consideration and certain women who meet certain criteria may be offered either
Medical management
Conservative management or
Surgical management.
With both medical and surgical management women will retain both of their fallopian tubes, but with surgical management most women will have surgery, which will involve removal of their fallopian tube (Salpingectomy).
A review article in 1996 suggested that women were “better off” without their fallopian tube if it had been affected by ectopic pregnancy. The reason for this was that there was a risk of leaving some of the pregnancy behind (persistent trophoblast) which would lead to further morbidity and further intervention. This would happen in about 15% of women. The other part of the coin was that there was no impairment in fertility if the tube was removed, and there would be a decrease in the 10% risk of repeat ectopic pregnancy if the tube were removed
If however the other tube was found not to be normal it was thought that the tube should be spared because though the risk of repeat ectopic pregnancy is 20% there was also the 50% chance of intrauterine pregnancy with 2 damaged tubes.
The modern approach to the management of ectopic pregnancy now differs and factors that should be taken into consideration are
1. The woman’s wishes if she meets prefixed criteria
2. The state of the other fallopian tube
3. How many children the woman already has and whether her family is complete or not
This is because more recent studies have shown that fertility rates are improved after salpingotomy compared with salpingectomy in one study 87% of women who sought to get pregnant after a salpingotomy did so compared to just over 60% of women who had a salpingectomy.
Women who are diagnosed with ectopic pregnancy should always ask their doctors before undergoing surgery whether they are able to perform a salpingotomy for ectopic pregnancy should the need arise, in order to save the tube and potentially improve fertility.
salpingectomy means removal of the fallopian tube
salpingotomy means opening up the tube whilst preserving it. the ectopic is removed and the tube is saved.
Before the mid 1950s most women (more than 80%) who had ectopic pregnancy would present once the pregnancy had ruptured, they would have internal bleeding and need a laparotomy (open surgery) to treat the ectopic pregnancy and this would mean removal of the affected tube.
Today most women are diagnosed with ectopic pregnancy before it ruptures; this is because of the availability of high-resolution ultrasound and the assay of human chorionic gonadotrophin bHCG that allows doctors to monitor the progression of an ectopic pregnancy.
To a reasonable extent doctors will take certain issues into consideration and certain women who meet certain criteria may be offered either
Medical management
Conservative management or
Surgical management.
With both medical and surgical management women will retain both of their fallopian tubes, but with surgical management most women will have surgery, which will involve removal of their fallopian tube (Salpingectomy).
A review article in 1996 suggested that women were “better off” without their fallopian tube if it had been affected by ectopic pregnancy. The reason for this was that there was a risk of leaving some of the pregnancy behind (persistent trophoblast) which would lead to further morbidity and further intervention. This would happen in about 15% of women. The other part of the coin was that there was no impairment in fertility if the tube was removed, and there would be a decrease in the 10% risk of repeat ectopic pregnancy if the tube were removed
If however the other tube was found not to be normal it was thought that the tube should be spared because though the risk of repeat ectopic pregnancy is 20% there was also the 50% chance of intrauterine pregnancy with 2 damaged tubes.
The modern approach to the management of ectopic pregnancy now differs and factors that should be taken into consideration are
1. The woman’s wishes if she meets prefixed criteria
2. The state of the other fallopian tube
3. How many children the woman already has and whether her family is complete or not
This is because more recent studies have shown that fertility rates are improved after salpingotomy compared with salpingectomy in one study 87% of women who sought to get pregnant after a salpingotomy did so compared to just over 60% of women who had a salpingectomy.
Women who are diagnosed with ectopic pregnancy should always ask their doctors before undergoing surgery whether they are able to perform a salpingotomy for ectopic pregnancy should the need arise, in order to save the tube and potentially improve fertility.
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