Journal of Minimally Invasive Gynecology
Removal of Essure Device
Section snippets
Study Objective
Little literature has been published regarding the removal of Essure devices. The aim of this study was to evaluate the safety and feasibility of removal of Essure devices hysteroscopically or laparoscopically because of perforation, pelvic pain, incorrect placement and nickel allergy after Essure sterilization.
Design
Case series.
Setting
University affiliated teaching hospital.
Patients
Since 2004 we have done approximately 1000 Essure sterilizations with the vaginoscopic approach. We performed a retrospective review of all patients who underwent removal of Essure devices in our hospital (n = 24). In 13 cases, devices were removed because of incorrect position, perforation or severe complaints. Also patients were referred from other hospitals with request of removal of devices (n = 11). The interval between placement of the devices and removal was between 10 days and 3 years.
Intervention
Hysteroscopic and laparoscopic removal of Essure devices.
Measurements and Main Results
In all 24 cases the devices were successfully removed. In total 32 devices were removed of which 20 were removed laparoscopically and 12 hysteroscopically. The mean operation time was 42 minutes (variation 15-70 min). All patients were released from our clinic the same day. No late or short term complications were registered.
Conclusion
Removal of Essure devices can be done either laparoscopically or hysteroscopically depending of the position of the device. It is a safe procedure which can be performed in a day care setting. Proper localisation before start of the procedure is very important. We experienced it is feasible to remove the devices beyond 12 weeks after placement. If sterilization is still requested we performed a laparoscopic sterilization by Filshie clips or tubectomy. We conclude that it is safe to remove