Removal of deeply inserted, nonpalpable levonorgestrel (Norplant) implants

Area of Science:

• Contraceptive device management
• Minimally invasive surgical procedures

Background:

• Contraceptive implants are effective but can become nonpalpable.
• Difficulties in removal can arise with deeply inserted implants.

Purpose of the Study:

• To describe a simple method for removing nonpalpable contraceptive implants.
• To outline an imaging technique for locating implants that are not easily retrieved.

Main Methods:

• Utilizing 6-8 cm3 of 1% lidocaine for local anesthesia.
• Making a single 1 cm incision for implant removal, without the need for sutures.
• Employing plain soft tissue X-rays (AP, lateral, and oblique views at 45-55 kVP) to pinpoint implant location if initial removal is unsuccessful.

Main Results:

• The described procedure facilitates easy removal of deeply inserted, nonpalpable contraceptive implants.
• Suturing is not required for the incision.
• X-ray imaging accurately identifies the location of implants missed by the initial removal attempt.

Conclusions:

• This technique offers a straightforward and effective approach to managing nonpalpable contraceptive implants.
• Radiographic localization is a viable strategy for implants that cannot be removed initially.
• The procedure minimizes invasiveness and patient discomfort.