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Case Reports in Obstetrics and Gynecology
Volume 2018, Article ID 7232637, 6 pages
https://doi.org/10.1155/2018/7232637
Case Report

Laparoendoscopic Single-Site Surgery for Management of Heterotopic Pregnancy: A Case Report and Review of Literature

1Department of Obstetrics and Gynecology, Southern California Kaiser Permanente, Kern County, 1200 Discovery Drive, Bakersfield, CA 93309, USA
2Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Baylor College of Medicine, 6651 Main Street, 10th Floor, Houston, TX 77030, USA
3University of Alabama, Department of Family Medicine, 801 Campus Drive, Tuscaloosa, AL 35487, USA
4University of Birmingham, School of Medicine, 1720 2nd Avenue, Birmingham, AL 35294, USA
5Division of Reproductive Medicine, Jinan Central Hospital Group, 105 Jiefang Road, Jinan City, Shandong Province 250013, China
6Department of Pathology & Immunology, Baylor College of Medicine, 6651 Main Street, 4th Floor, Houston, TX 77030, USA
7Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, Lincoln Medical and Mental Health Center, 234 East 149th Street, Bronx, NY 10451, USA

Correspondence should be addressed to Xiaoming Guan; ude.mcb@gnimoaix

Received 10 February 2018; Revised 15 April 2018; Accepted 26 April 2018; Published 4 July 2018

Academic Editor: Erich Cosmi

Copyright © 2018 Shadi Rezai et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Heterotopic pregnancy occurs when two pregnancies occur simultaneously in the uterus and an ectopic location. Treatment includes removal of the ectopic pregnancy with preservation of the intrauterine pregnancy. Treatment is done laparoscopically with either a Laparoendoscopic Single-Site Surgery (LESS) or a multiport laparoscopic surgery. Case. We present a case of a first trimester heterotopic pregnancy in a 42-year-old gravida 5, para 0-1-3-1 female with previous history of left salpingectomy, who underwent laparoscopic right salpingectomy and lysis of adhesions (LOA) via Single-Incision Laparoscopic Surgery (SILS). Conclusion. Although LESS for benign OB/GYN cases is feasible, safe, and equally effective compared to the conventional laparoscopic techniques, studies have suggested no clinically relevant advantages in the frequency of perioperative complications between LESS and conventional methods. No data on the cost effectiveness of LESS versus conventional methods are available. LESS utilizes only one surgical incision which may lead to decreased pain and better cosmetic outcome when compared to multiport procedure. One significant undesirable aspect of LESS is the crowding of the surgical area as only one incision is made. Therefore, all instruments go through one port, which can lead to obstruction of the surgeon’s vision and in some cases higher rate of procedure failure resulting in conversion to multiport procedure.