One hundred and seventeen consecutive patients with diagnosis of
ectopic pregnancy admitted to Temple University Hospital between October 1989 and March 1992 were divided into two groups. Group 1 consisted of 56 patients with operative laparoscopy and Group 2 consisted of 61 patients treated by
laparotomy. The two groups were similar for age, race, parity, gestation, presentation, and location of the ectopic gestations. Fifty seven percent of patients in the laparoscopy group were treated by
salpingectomy and 43% by
salpingostomy, compared to 84% and 16% respectively in the
laparotomy group. Mean
operative time for laparoscopy was 58 min and 42 min for
laparotomy. Complication rates were similar in the two sub-groups. Only two patients in the laparoscopy group required subsequent
laparotomy, one to assure hemostasis and one, 5 weeks following surgery, for persistent trophoblastic disease. Operative laparoscopy was associated with a significantly shorter length of
hospital stay (1.25 v. 4.39 days). This reflected in a lower cost of
hospital stay ($10,105 vs. $13,608). The present data demonstrates that operative laparoscopy is not only safe and effective, but also more economical than open
laparotomy in the treatment of
ectopic pregnancies. This procedure is expected to replace
laparotomy for the treatment of most cases of tubal
ectopic pregnancy.