LAPAROSCOPIC MANAGEMENT OF TUBAL ECTOPIC PREGNANCY: SINGLE-PORT VERSUS CONVENTIONAL MULTI-PORT LAPAROSCOPY

Study objective: Evaluation of intraoperative (IO) and immediate postoperative (PO) outcome of single-port laparoscopy (SPL) compared to conventional multi-port laparoscopy (CMPL) for management of tubal ectopic pregnancy (TEP). Design: Patients presented with acute abdominal manifestations during pregnancy were clinically evaluated and cases diagnosed with tubal ectopic pregnancy as confirmed by transvaginal ultrasonography (TVU) and higher β-hCG levels were enrolled in the study. Patients: 52 patients had TEP diagnosed and fulfilling the inclusion criteria were randomly allocated into two equal groups according to laparoscopic procedure. Interventions: SPL was conducted through a single 1.5-2 cm vertical umbilical incision and performed using standard laparoscopic instruments used for CMPL. Collected IO data included the need for conversion to laparotomy; operative time and need for blood transfusion. Collected PO data included pain scores and frequency of requests of PO analgesia, time of 1st ambulation and oral intake, and duration of PO hospital stay. Patients' satisfaction by cosmetic wound appearance was evaluated 3-months after surgery using a 5-points satisfaction score. Measurements and main results: Total conversion to laparotomy was 3.8% in both groups. Pain scores were significantly lower till 4-hr PO in patients of SPL compared to patients of CMPL group. SPL patients could ambulate within shorter PO time and more patients could ambulate within 3-hr PO. Mean duration of hospital stay was shorter in SPL patients with a higher frequency of patients discharged within 24-hr PO. Frequency of patients satisfied by wound appearance was higher with SPL than CMPL. Conclusion: SPL improves outcome of laparoscopic management of tubal ectopic pregnancy with significantly better short-term outcome and satisfactory cosmetic appearance compared to CMPL.