Laparoscopic Cornuectomy as a Technique for Removal of Essure Microinserts

Area of Science:

• Minimally Invasive Gynecological Surgery
• Female Sterilization Reversal Techniques
• Medical Device Removal

Background:

• Growing concerns regarding adverse outcomes associated with Essure microinserts, including pelvic pain and nickel allergy, have prompted increased demand for device removal.
• Previous methods for Essure removal, such as hysteroscopic or standard laparoscopic approaches, carry risks of incomplete extraction due to device fibrosis.
• A need exists for a reliable surgical technique to ensure complete removal of Essure microinserts.

Purpose of the Study:

• To present a laparoscopic surgical technique for the complete en bloc removal of Essure microinserts.
• To demonstrate the feasibility and safety of this approach in a tertiary care setting.

Main Methods:

• A laparoscopic approach involving salpingectomy and mini-resection of the uterine cornua to the endometrial level was employed for Essure removal.
• The procedure utilized standard laparoscopic and electrosurgical instruments through a supraumbilical port and two lower quadrant ports.
• This technique aims for the complete, en bloc extraction of the fallopian tubes and embedded Essure microinserts.

Main Results:

• The laparoscopic en bloc resection technique successfully achieved complete removal of Essure microinserts in the presented case.
• The surgical approach was technically straightforward, performed in a tertiary care hospital operating theatre.
• The procedure was associated with minimal blood loss, highlighting its safety and efficiency.

Conclusions:

• En bloc resection of the fallopian tubes and uterine cornua is a feasible and effective laparoscopic method for ensuring complete Essure microinsert removal.
• This technique offers a reliable solution for patients experiencing discomfort or adverse effects post-Essure placement.
• The described laparoscopic approach is technically straightforward and minimizes surgical complications.