Traditionally this used to involve a laparotomy (an open incision on the lower abdomen)
With the advancement of technology and surgical skill the majority of women should have their operation by means of operative laparoscopy (keyhole surgery), under general anaesthetic. This is where a telescope is inserted through the bellybutton (umbilicus) with 2 other small incisions on the lower abdomen. Small instruments are then inserted through these lower incisions to perform the surgery.
The royal college of obstetricians and gynaecologists suggest that all women who are not collapsed or bleeding excessively internally should have the procedure by this keyhole technique.
There is no doubt about the superiority of laparoscopy over laparotomy for the management of ectopic pregnancy
Length of stay in hospital is shorter
Time to recovery is quicker
Pain relief requirements are less
Blood loss during the operation is less
Development of scar tissue after the operation is less
In good centers 100% of women who are not collapsed who require surgery for the management of their ectopic pregnancy.
In the past ectopic pregnancies outside the tube were routinely operated on by means of laparotomy in modern centres this has changed with most ovarian, cornual, and caesarean section scar pregnancies having laparoscopic surgery rather than open when surgery is required.
In some centres even when there has been internal bleeding where there is a good surgeon and surgical team experienced in laparoscopic surgery it is possible to have a laparoscopy.
Even for pregnancies that are non-tubal e.g. cornual/interstitial, ovarian and caesarean scar ectopics there is an increasing trend to laparoscopic management.
Hospital stay after an ectopic pregnancy particularly when managed by laparoscopy is 24hours and it will take a week or two to recover physically. For some women psychological recovery may take a bit longer and talking to a counselor if necessary can help the holistic healing process.