How Long Is the Surgery for Ectopic Pregnancy?

Ectopic pregnancy surgery may take 30 minutes to 2 hours.

Ectopic pregnancy surgery can be either laparoscopic (via camera and smaller cuts) or via laparotomy (surgery by opening the belly). If the physician prefers laparoscopic surgery, it will take about 30 minutes to 1 hour. However, if the physician chooses laparotomy, it might take longer to complete. The patient should return to the ward within 1 to 2 hours.

Ectopic pregnancy is a condition where the embryo implants outside the uterus, especially in the fallopian tubes.

Surgery for ectopic pregnancy is indicated when

• The patient is not fit for medical therapy.
• There is a failure of medical treatment.
• The patient has both ectopic pregnancy and intrauterine pregnancy.
• The patient’s vitals are abnormal or unstable (irregular, lower or high pulse; poor oxygen levels and; low blood pressure)

However, the surgery would be avoided when

• The patient has an ectopic pregnancy, which is treatable with medicines.
• The patient has an underlying medical condition that would make the surgery difficult.

The physician either chooses a laparoscopy or laparotomy to resolve the ectopic pregnancy. The surgery is generally performed under general anesthesia. For ectopic pregnancy that hasn’t ruptured, the physician attempts to remove the products of conception present in the ampulla region of the fallopian tube (salpingotomy). In some cases, the physician identifies the tube that contains the ectopic pregnancy and separates it from the surrounding structures (salpingectomy). In laparoscopic surgery, the physician makes two to three cuts in the lower belly. Next, the physician inserts a laparoscope and small surgical tools to access the pelvic organs. The physician makes a cut about 1 to 2 cm long on the fallopian tube. Fluid under pressure is injected into the tube to dislodge the pregnancy. The physician may also perform an open surgery in the case of severe bleeding or when the laparoscopic technique has been a failure.

The patient should follow these instructions after the surgery

• Rest for a week after the surgery, even if she feels better sooner.
• Avoid lifting anything heavier than 10 pounds (4.5 kg), which would strain the incision.
• Avoid exercises or strenuous activities until the doctor says so.
• Climb the stairs slowly with a pause after every step.
• Don’t attempt driving for a few days after the surgery.
• Walk as often as she can.
• Avoid standing for long periods.
• Don’t engage in sexual activities unless the physician says it is safe to do so.
• Continue with deep breathing exercises taught in the hospital.
• Prevent constipation by
  • Drinking six to eight glasses of water every day.
  • Eat fruits, whole grains, vegetables and leafy green vegetables.
  • Use a laxative or a mild stool softener.
• Use mild soap and water to wash the incision and pat it dry.
• Shower or bathe regularly.

If the patient observes the following symptoms, she should call her physician immediately

• Redness, swelling or drainage at the incision site.
• Fever of 100.4° Fahrenheit.
• Pain that doesn’t resolve with medicine.
• Worsening stomach pain and swelling.
• Vaginal discharge or bleeding.
• Dizziness or fainting.
• Nausea and vomiting.

The complications of surgery include

• Cervical pregnancy: The ectopic pregnancy implants in the cervix.
• Severe hemorrhage
• Damage to the bowel, bladder and/or uterus that would require another major surgery
• Bruising
• Wound infection
• Hernia at the site of entry
• Shoulder tip pain
• Wound gaping (a wound that is wide and open)
• Persistent pregnancy tissue