Robotic Assisted Laparoscopic Wedge Resection of a Large Cornual Ectopic Pregnancy

Study Objective To demonstrate the steps of a wedge resection of a large cornual ectopic pregnancy using a robotic assisted approach. Design A guided explanation of the surgery using video. Setting The surgery was completed at a university hospital using the Da Vinci Xi Robot. Patients or Participants A 38-yo G7P1051 with a history of chronic hypertension who was incidentally found to have a cornual ectopic pregnancy measuring 11 weeks 4 days on her initial prenatal ultrasound. Interventions Robotic Assisted Laparoscopic Cornual Wedge Resection. Measurements and Main Results On initial prenatal ultrasound, the patient was found to have a cornual ectopic pregnancy on the right. Crown rump length measured 47mm corresponding with a gestational age of 11 weeks and 4 days. She was asymptomatic. She presented immediately to the hospital and underwent an urgent robotic assisted laparoscopic cornual wedge resection that evening. Estimated blood loss was 100cc. She did well postoperatively and went home the same day. Conclusion We present a case of a robot assisted wedge resection of a large cornual ectopic pregnancy as an alternative to straight stick laparoscopy or laparotomy. Although robotic assisted cases are known to have longer operating times, as with myomectomy, a robot approach can potentially help to decrease blood loss when managing large cornual ectopic pregnancies.