Design: Observational Study.

Setting: A tertiary care hospital in India.

Patients or Participants: As per diagnostic criteria, the patient had a gestational sac with or without fetal pole in the anterior part of the uterine isthmus; an empty uterine cavity without contacts with the sac; a clearly visible empty cervical canal; and absence of, or a defect in, the myometrial tissue between the bladder and the sac. The myometrial thickness was 3 to 5 mm. A total of 18 patients were enrolled.

Interventions: Resection of CSP was done under general anaesthesia, using a resectoscope with monopolar current.

Measurements and Main Results: Out of 18 CSP cases 8 had been operated by using hysteroscope. All 8 cases of ectopic gestations were removed entirely by resectoscope. Out of those 8 patients, 1 had bleeding post operatively, controlled by inserting foley’s bulb inflated with 30 ml of water. Rest of the cases were managed by laparoscopy.

Conclusion: Operative hysteroscopy might be recommended as a first-line treatment modality for patients with a CSP, especially when myometrial thickness between bladder and gestational sac is 3 to 5 mm. If every CSP patient is treated with laparoscopy, it could increase the morbidity. This raises the issue of when to choose hysteroscopic surgery only and when to add laparoscopy.