If a woman may not be a candidate for medical therapy for some particular reasons, such as if she is being in shock (a condition, which is considered hemodynamically unstable), if she has an advanced ectopic pregnancy (which may be determined with the help of blood test, which measures the level of hCG hormone, and it proves to be higher than possible as well as with the help of ultrasound, if it shows a large pregnancy sac), or if a woman suffers from moderate to severe feeling of pain, it becomes possible to terminate her ectopic pregnancy with the help of a surgery.
There exist two kinds of surgeries, conducted with the aim to terminate an ectopic pregnancy. These are: “conservative surgery” and “radical surgery”.

“Conservative surgery” involves making a small incision in the fallopian tube, in which the ectopic pregnancy is located, at the site of the pregnancy. After that depending on some circumstances, the surgeon applied either laparoscopy, or a larger, major abdominal incision with the aim to get to the fallopian tube. As soon as the incision is made, the tissue of the ectopic pregnancy is being removed away from the tube and the tube gets healed in a natural way. With the help of conservative surgery, fallopian tube may be preserved. There are cases, though rare enough, when some of the ectopic pregnancy tissue is left behind unintentionally. Then the postoperative application of methotrexate, or in the worst case, another surgical procedure may be necessary.

Anyway, when the tube gets healed well and quickly enough, it is quite possible that it may function adequately in the future, and the woman may be even to conceive, carry pregnancy to term and deliver in a normal way. However, when the tube gets healed poorly, or in case if it was damaged by the ectopic pregnancy, leaving it in place can possibly make a future ectopic pregnancy more likely to occur.

“Radical surgery” involves removing all or at least some part of the fallopian tube, in which the ectopic pregnancy was located. It is conducted through a procedure, which is called salpingectomy. Just as well as “conservative surgery”, it may be performed either by laparoscopy or a larger abdominal incision.
There is one advantage in the removing the affected tube – it is quite a lower risk of accidentally leaving some of ectopic pregnancy tissue behind, thus the probability of the postoperative application of methotrexate, or of another surgical procedure necessity lowers significantly.
To the disadvantage of the radical surgery may be referred the decrease in further fertility, which is usual to be experienced when one of the fallopian tubes is absent.