Pregnancy: Operative laparoscopy for ectopic pregnancy: how experienced should the surgeon be?

The purpose of this study was to assess the efficacy of laparoscopicsurgery for ectopic pregnancy in a general hospital in Paris,where most of the surgeons are still in training. During a periodof 20 months, 100 cases of ectopic pregnancy were diagnosedand treated by the attending residents. Nine cases requireda laparotomy due to heavy bleeding or interstitial ectopic pregnancy.Most of the other cases were treated laparoscopically, witheither salpingectomy (70 cases) or linear salpingostomy (19cases). Complications of the laparoscopic surgical procedureswere rare. There was one failure of linear salpingostomy thatrequired a second intervention (5.3% failure rate); there wasone case of urinary retention that resolved after 48 h; andone case of fever above 38°C that responded well to antimicrobialtherapy. In conclusion, we have shown that the current notionthat laparoscopic surgery is preferred to conventional abdominalsurgery for the treatment of ectopic pregnancy, can be appliedto a public gynaecological centre with young inexperienced residents,supervised by experienced gynaecologists.