A 33-year-old woman with a known right interstitial ectopic pregnancy is taken for laparoscopy. The surgeon notes a 3 mm unruptured bulge in the proximal right tube embedded in the myometrium. Which surgical technique is most appropriate?
- A Cornual wedge resection with salpingectomy ✓
- B Linear salpingostomy with tubal preservation
- C Total hysterectomy
- D Local methotrexate injection into the cornual mass
Correct answer: A. Cornual wedge resection with salpingectomy
Explanation
Interstitial (cornual) ectopic pregnancy is best managed by cornual wedge resection with removal of the affected tube due to the high risk of catastrophic hemorrhage and poor healing at this site. Simple salpingostomy leaves residual trophoblast in the myometrium and carries high persistent trophoblast risk. Local injection without resection is insufficient. Hysterectomy is reserved for uncontrollable hemorrhage in patients not desiring fertility.
Reference: Te Linde's Operative Gynecology, 12th ed.
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Written and medically reviewed by the StethoPrep medical team.