ASSISTANT:
ANESTHESIOLOGIST:
OPERATION:
1.
Diagnostic laparoscopy.
2.
Right salpingectomy.
PREOPERATIVE DIAGNOSIS:
POSTOPERATIVE DIAGNOSIS:
fallopian tube.
ANESTHESIA:
Ectopic pregnancy.
Ectopic pregnancy of right
General anesthesia.
INDICATIONS: The patient is a 41-year-old female G 5 P 2
who presented to the emergency room with a complaint of low
abdominal pain. The pelvic ultrasound shows empty uterus.
There was a 1.9 cm mass on the left adnexa suspicious for
ectopic pregnancy for which the patient was recommended to
have a diagnostic laparoscopy to rule out ectopic
pregnancy.
FINDINGS: Ectopic pregnancy of the right fallopian tube.
There is approximately 20 cc of hemoperitoneum.
SURGICAL PROCEDURE: The patient was brought to the
operating room, placed in the supine position, and
underwent induction of general anesthesia without any
problem. She was then placed in the lateral lithotomy
position, prepped and draped as usual fashion for an
abdominal procedure. A Foley catheter was inserted into
the bladder for continued drainage. The attention was then
paid to the abdomen by performing a small vertical incision
at the umbilicus. A #10 mm trocar was inserted into the
abdomen without any problem. The trocar was then removed
and a 10 mm scope was inserted into the abdomen to the
point of the umbilicus. Carbon dioxide gas was insufflated
and after adequate pneumoperitoneum had obtained.
A 2nd
puncture on the left lower quadrant of the abdomen was then
performed, 5 mm trocar was inserted into the pelvic cavity
under direct visualization. With the scope, careful
inspection of the uterus revealed the patient had
approximately 20 cc of hemoperitoneum in the posterior culde-sac. There was also ectopic pregnancy on right
fallopian tube, almost completely the right tube. A 3rd
trocar was inserted into the right lower quadrant of the
abdomen. The tube was then dissected and removed using
Harmonic instrument. The specimen was then removed out of
the abdominal cavity. Irrigation was performed and
hemostasis was found to be good. The procedure was
completed by deflating the carbon dioxide gas. Local
anesthesia was installed along the incision to prevent
postop pain. The incision was then reapproximated using 40 Vicryl suture. The patient was then placed back in
supine position, reversed from anesthesia, and transferred
back to the recovery room in good general condition.