A laparoscopic approach to cesarean scar ectopic pregnancy.

Abstract Cesarean scar pregnancies confer serious risk and severe morbidity. Appropriate management is key to preventing complications. While expectant management is usually contraindicated, the ideal combination of medical or surgical treatments is unclear and must be tailored to the patient’s preferences and stability, provider skill, and available resources. In this article, we present a combined medical and surgical approach successfully employed for the termination and excision of a cesarean scar pregnancy of 12 weeks gestation in a patient desiring uterine preservation. A video is included demonstrating the surgical steps of a laparoscopic approach used to safely resect the pregnancy and cesarean scar with minimal blood loss. The management technique described can be utilized to effectively resolve cesarean scar pregnancy, possibly decrease risk of recurrence, and preserve future fertility with a minimally invasive outpatient surgery.