INTRODUCTION: Ectopic pregnancies account for ∼2% of pregnancies worldwide. A recent meta-analysis compared the management of ectopic pregnancies via single-site laparoscopy to conventional laparoscopy and found patients who underwent single-site laparoscopy to have reduced initial postoperative pain. Previous studies on single-site laparoscopy for management of ectopic pregnancies have also found no significant difference in bleeding, intraoperative time, or complications compared to standard laparoscopy. Given the additional advantage of eliminating additional port complications and improved cosmetic results, single-site laparoscopy should be considered as an option during surgical planning. OBJECTIVE: The objective of this film is to demonstrate a unique presentation of an 11-week intact tubal ectopic pregnancy with a visible heartbeat on ultrasound that was successfully managed via single-site laparoscopic salpingectomy. METHODS: This is a case report of a 27-year-old female G2P0010 who presented with worsening lower abdominal pain. Ultrasound revealed an ectopic pregnancy with a visible heartbeat and large hemoperitoneum. The patient was consented for a single-port laparoscopic salpingectomy. Patient was placed in dorsal lithotomy position under general anesthesia. A 2.5-cm umbilical incision was made down to the subcutaneous tissue. The rectus fascia was incised and entered under direct visualization with care to avoid injurying to underlying organs. A multichannel port gel retractor was placed at the umbilicus. Upon entry, approximately 1800 cc of hemoperitoneum was noted and evacuated. A left tubal ectopic pregnancy was then clearly visible and salpingectomy performed. RESULTS: Management of the ectopic pregnancy was succesfully performed via single-site laparoscopy. The specimen contained a ruptured segment of left fallopian tube with gestational sac and fetus, measuring 3.4 × 2.6 × 1.2 cm. The fetal crown to rump length measured 4.2 cm with a fetal foot measuring 0.4 cm. CONCLUSIONS: To our knowledge, this is the largest documented intact tubal pregnancy at 11 weeks of gestation with a visible heartbeat on imaging to be successfully and safely managed via single-site laparoscopic salpingectomy. This supports single-site laparoscopy to be a noninferior, viable alternative to management of ectopic pregnancies.
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