Abstract
Essure is designed as a hysteroscopically placed permanent birth control. Removal
of the Essure microinsert can be a technically challenging procedure. Requests for
removal are uncommon but do occur. Although hysteroscopic and laparoscopic removal
has been reported, there is limited information available describing appropriate surgical
technique.
There have been six patients requesting Essure removal at our institution (one approximately
2 years after placement). Based on this experience, we have developed specific counseling
points and surgical principles for laparoscopic removal: avoid injection of a hemostatic
solution into the fallopian tube; avoid excessive traction on the coils; avoid cauterization
of the outer coil; follow the Essure coil into the interstitial end of the fallopian
tube to ensure complete removal of the insert; perform a salpingectomy rather than
a salpingostomy.
By taking into account these principles, key preoperative counseling points can be
discussed, and laparoscopic Essure removal years after placement can be accomplished
in a safe and deliberate fashion.
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References
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Article info
Publication history
Published online: January 04, 2013
Accepted:
November 26,
2012
Received in revised form:
November 26,
2012
Received:
July 16,
2012
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
