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From March 1989 to December 1995, 194 cases of ectopic pregnancy were diagnosed in our centre and treated following a strict laparoscopic protocol. A total of 193 cases was treated surgically and only one case was treated medically, because general anaesthesia was contraindicated. Altogether, eight laparotomies (4.1%) had to be performed; three primary and five secondary, due to uncontrollable haemorrhage (n = 3) and too large pregnancy size (n = 2). Peri- or postoperative complications were encountered in 24 cases (12.4%). Residual disease occurred in 14 cases (7.2%), all after a technically successful operative laparoscopic procedure. These cases received adjuvant therapy, either systemic administration of methotrexate or a second intervention. The overall laparoscopic cure rate was 88.1% (171/194). Conclusive follow-up data could be obtained concerning 110 cases with an active desire for pregnancy. Overall conception rate was 77.3%, with an ongoing pregnancy rate of 81.2% and a recurrency rate of 10.6%. A critical overview of the available data on non-surgical approaches is made, while the reported results are evaluated according to published data. It is concluded that at this stage a surgical approach by means of operative laparoscopy should remain the gold standard in treating ectopic pregnancies.

Ectopic pregnancy: let's cut! Strict laparoscopic approach to 194 consecutive cases and review of literature on alternatives