Fig. 1

Ruptured interstitial pregnancy managed by laparoendoscopic single-site cornuotomy with intraoperative autologous blood cell salvage and donation. A 29-year-old woman (gravida 3, para 2) was transferred under the suspicion of ectopic pregnancy at estimated 7 weeks of gestation. The serum β-human chorionic gonadotropin value was 50,736 mIU/mL, and the shock index was 0.88. The hemoglobin value was 6.5 g/dL. a A coronal view of three-dimensional computerized tomographic angiography showing a prominent vascular mass with extravasation (long arrow) supplied from the ascending branch of the left uterine artery (short arrow) with an anastomosing right uterine artery (arrowhead) in the left cornual region, indicating ruptured interstitial pregnancy. b Surgical working space secured by intra-abdominal fan retractor system (arrow) combined with wound retractor (arrowhead). c Emergency laparoendoscopic single-site surgery showing ruptured left interstitial pregnancy (arrow) with massive hemoperitoneum. d A Continuous Autotransfusion System (Fresenius Kabi, Bad Homburg, Germany) utilized for intraoperative blood cell salvage. e Hemostasis achieved by intracorporeal suturing and extracorporeal knot-tying after removal of the gestational products. f Single surgical wound limited to the umbilicus after skin closure. The amount of intraperitoneal bleeding was 1000 mL, and 505 mL of retrieved blood was transfused back to the patient. The hemoglobin value on postoperative day 1 was 10.0 g/dL. Postoperatively, the systemic administration of methotrexate was required three times due to persistent ectopic pregnancy