Design: Case report with surgical video.

Setting: Academic tertiary care hospital. Patient positioned in dorsal lithotomy using Yellofin stirrups.

Patients or Participants: Single patient

Interventions: 43 y/o G8P5025 with a history of 5 prior c-sections and abdominoplasty initially presented to maternal fetal medicine for dating scan in the setting of an undesired pregnancy. Cesarean scar pregnancy measuring 6 weeks 6 days by crown-rump length was confirmed by ultrasound, cardiac activity not observed. Patient opted for surgical management and was referred to minimally invasive gynecologic surgery. Patient then underwent operative hysteroscopy using a bipolar resectoscope to remove the ectopic pregnancy.

Measurements and Main Results: Hysteroscopic excision of cesarean scar pregnancy was completed successfully with minimal blood loss as well as no intra or post-operative complications. Surgical technique reviewed in the video. Pathology was consistent with products of conception. Patient was discharged on the day of surgery and had an uncomplicated surgical recovery.

Conclusion: Hysteroscopic resection of a cesarean scar pregnancy is a safe and feasible surgical treatment strategy.