Abstract:

Vaginal natural orifice transluminal endoscopic surgery combines vaginal surgery with laparoscopic surgery, and usually takes the vaginal vault as the path to enter the abdominal cavity. We analyze two cases who diagnosed with ectopic pregnancy and treated by v-NOTES. One of the patients was unmarried and childless, no specific lesion site was found during v-NOTES, and MTX was selected for conservative medication. Postoperative serum β-hCG continued to rise, and the adnexal mass increased, thereupon transumbilical laparo-endoscopic single-site surgery (TU-LESS) was performed to remove fallopian tube. Another patient was found pelvic adhesions when the posterior fornix was opened, and it was difficult to enter. After resection of the fallopian tube, considering that pelvic adhesions may lead to residual pregnancy products, TU-LESS was required. Through two cases of operation, v-NOTES was found to be more limited operation field of vision than traditional laparoscopic surgery, which not only affects the determination of lesions, but also leads to a relatively prolonged operation time, and has certain limitations in the treatment of ectopic pregnancy.

Key words: Pregnancy, ectopic, Pregnancy, tubal, Laparoscopy, Umbilicus, Vagina