The study investigates the feasibility, safety, and outcomes of a simultaneous surgical approach for cesarean scar ectopic pregnancy (CSEP). CSEP is a prevalent and serious form of ectopic pregnancy requiring swift intervention. The research explores using hysteroscopy and laparoscopy concurrently to manage the CSEP and repair the uterine scar defect. The procedure involved hysteroscopic-guided evacuation and a double-layer laparoscopic repair, followed by a second hysteroscopy to confirm the repair's effectiveness.

Inclusion Criteria:

• Patients with positive clinical and lab pregnancy diagnosis;
• Patients with history of at least one previous Cesarean section;
• Patients with Transvaginal ultrasound documenting Cesarean scar ectopic Pregnancy;

Exclusion Criteria:

• Patients with were extensive adhesions between the mass and the urinary bladder on MRI;
• Patients with myomas, polyps, endometrial hyperplasia, and cancers of the cervix or endometrium;
• Patients with a body mass index (BMI) of >35kg/m2;
• Patients with previous abdominal surgeries with possible difficulties during laparoscopy;
• Patients with menstrual irregularities, or coagulation disorders.