Essure Removal via Salpingectomy With Cornual Resection vs. Total Laparoscopic Hysterectomy—A Case Series [8H

Abstract

INTRODUCTION: The Essure is most commonly removed by bilateral salpingectomy with cornual resection (BS-CR) or total laparoscopic hysterectomy with bilateral salpingectomy (TLH-BS); however, limited data exists on Essure removal. The purpose of this study is to evaluate the safety and efficacy of Essure removal via BS-CR and TLH-BS. METHODS: A retrospective chart review and follow-up patient survey were conducted at an academic institute of patients undergoing surgical removal of the Essure device via BS-CR or TLH-BS between 2014 and 2017. RESULTS: 58 patients underwent Essure removal-33 via BS-CR and 25 via TLH-BS. The mean operative time for BS-CR was 61 minutes vs. 70.5 minutes for TLH-BS. All procedures had an estimated blood loss of less than 50mL. There were no intraoperative complications. Mean length of stay for BS-CR was 572.6 minutes vs. 772.4 minutes for TLH-BS. Postoperatively, 1 patient who underwent BS-CR presented to the emergency room (ER) due to subjective fevers; no pathology was identified. One TLH-BS patient was admitted with vaginal cuff cellulitis, and one presented to the ER for vaginal bleeding without cuff separation/dehiscence. Satisfaction was noted in 30/32 (93.8%) patients who underwent BS-CR vs. 20/20 (100%) who underwent TLH-BS. Improved quality of life was reported in 29/32 (90.6%) of patients who underwent BS-CR vs. 19/20 (95.0%) who underwent TLH-BS. 31/32 (96.9%) patients who underwent BS-CR reported they would undergo removal again vs. 19/20 (95.0%) who underwent TLH-BS. CONCLUSION: Bilateral salpingectomy with cornual resection and TLH-BS are likely comparable methods for Essure removal, with overall high satisfaction.