In the last decade, laparoscopic surgery had become popular in gynaecological surgery. Advantages of the minimally invasive approach are reduced postoperative morbidity, less postoperative pain and, consequently, less analgesic requirement, early resumption of intestinal activity and reduced length of hospital stay. Ectopic pregnancy occurs in approximately 1–2% of pregnancies and the incidence is increasing. The most common site of ectopic pregnancy is the ampullary tubal portion and less frequently other parts of the tube and uterus (cornual and caesarean scar pregnancy), the cervix, the ovary and the abdominal cavity are affected. All variants of extrauterine pregnancy can be treated by a minimally invasive approach in the majority of cases. Moreover, minimally invasive surgery can be considered the standard therapeutic option for adnexal masses which represent one of the most common gynaecological diseases. In this chapter, we describe the main surgical techniques concerning these two pathologies, which are of great interest for daily gynaecological practice.

A 34-year-old gravida 3, para 3 is undergoing an interval bilateral salpingectomy for permanent sterilization. She is currently using combined oral contraceptive pills (containing ethinyl estradiol/norethindrone) for contraception. Because of side effects associated with the pill, she has opted for permanent sterilization. She understands sterilization is a permanent procedure and is certain she has completed her family. Her pre-procedure pregnancy test was negative. All her deliveries were spontaneous vaginal deliveries. She has no history of easy bleeding or bruising. She has no past medical or surgical history. She is not taking any other medications and she has no known drug allergies.