Abstract
The purpose of this video is to describe a simple, effective, and safe technique for laparoscopic removal of Essure implants. We focus on the steps of the procedure and also techniques to overcome possible complications. Essure implants can be associated with pelvic pain, which may warrant their removal. We present recordings from our laparoscopic Essure removal procedure. Our steps for safe and effective laparoscopic technique consist of: 1) injection of vasopressin through the abdominal wall into uterine cornua via spinal needle to decrease blood profusion to the operative site; 2) use of a vessel sealer device to coagulate and dissect the mesosalpinx to access the cornua and expose the implants; 3) use of gentle traction, open-and-spread, and twisting technique to remove the implants; and 4) completion of the salpingectomy only after the implants have been entirely removed. Additional tips and tricks for successful outcomes are highlighted. This technique for laparoscopic removal of Essure implants minimizes blood loss and allows for concomitant salpingectomy to achieve permanent sterilization. Our video presentation allows the viewer to easily learn this safe and effective technique.
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