Comment je fais… l’ablation des implants Essure® par mini-cornuectomie sans risque de fracture ? (avec vidéo)

Chêne, Geneviève; Lebail-Carval, K; Azzi, Caroline; Chabert, Philippe; Méllier, G; Lamblin, G.

doi:10.1016/j.gofs.2018.05.010

Cited by 2 publications

(5 citation statements)

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“…SD, standard deviation.1One case of intestinal injury during primary open trocar insertion immediately repaired through the umbilical incision (Clavien-Dindo grade 3) [18]. 2Two cases of urinary tract infection treated with antibiotics (Clavien-Dindo grade 2) [18]. 3Concomitant hysterectomy / myomectomy.…”

Section: Resultsmentioning

confidence: 99%

“…1One case of intestinal injury during primary open trocar insertion immediately repaired through the umbilical incision (Clavien-Dindo grade 3) [18]. …”

Section: Resultsmentioning

confidence: 99%

“…Mini-cornuectomy [18]. The device was gently grasped and elevated using atraumatic forceps and monopolar scissors were then used to make a small, circular cornual incision.…”

Section: Methodsmentioning

confidence: 99%

“…Criteria based upon the symptom chronology, severity and response to medical treatments in the absence of other explanatory pathologies, have been suggested to assist the clinician and the patient when deciding whether to undergo removal of Essure ® devices [18]. Furthermore, in the absence of abnormally sited Essure ® devices, the varied and often non-specific nature of women’s presenting symptoms make it difficult for the clinician to formulate effective management plans.…”

Section: Commentmentioning

confidence: 99%

“…Furthermore, the latter technique was associated with device fractures in 28.5% of cases presumably because of difficulty in controlling tensile pressures when applying traction on the fragile devices. Thus, mini-cornuectomy seems the preferable technique because potential problems arising from fragmentation and retention of components of the devices within the peritoneal cavity are avoided [18]. Only the removed Essure ® devices need to be inspected on a surgical drape to confirm they have been fully removed (Fig.…”

Section: Commentmentioning

confidence: 99%

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Quality of life after laparoscopic removal of Essure® sterilization devices

Chêne

Cerruto

Moret

et al. 2019

European Journal of Obstetrics & Gynecology and Reproductiv

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Objective(s) To assess changes in quality of life after laparoscopic removal of Essure ® sterilization devices (Bayer AG, Leverkusen, Germany). Study Design In this prospective observational study in an academic research hospital, 80 women with new or worsening symptoms since placement of Essure ® sterilization devices undergoing subsequent surgical removal were included. Laparoscopic removal of Essure ® devices and salpingectomy with or without cornual excision were performed. Concomitant uterine procedures could be associated where indicated for gynaecological complaints. Comparison using the T student test for coupled series was done in this before-and-after study. Results Health related quality of life (HRQL) was the primary outcome measured by the Short Form 12 (SF-12) questionnaire and a global 10 cm visual analogue scale (VAS). Secondary outcomes included assessment of pain, using continuous (VAS) and ordinal scales (Modified McGill Pain Questionnaire), menstrual bleeding (pictorial blood loss assessment chart (PBAC) score) and surgical feasibility and safety. There was a significant improvement in quality of life in both mental and physical health aspects of the SF-12 (34.02 (+/−1.19) vs. 49.61 (+/−1.42, P < .0001) and 36.55 (+/−0.99) vs. 43.32 (+/−1.18, P < .0001 respectively) as well as global VAS assessment (+2.91 (SD +/−0.27)) at the end of the first post-operative month. These improvements were maintained at three and six months. Mean pain decreased at one month following surgery compared to baseline (VAS 3.6 (+/−0.36) to 1.4 (+/−0.25), P < .0001 and McGill pain score 18.70 (+/−1.88) to 4.73 (+/−0.90), P < .0001). Improvements of a similar magnitude were observed when analysis was restricted to the 47 women without concomitant uterine surgery. No significant changes in bleeding were seen following of Essure ® device removal. Planned procedures were all successfully completed. Conclusion Laparoscopic removal of Essure® devices in symptomatic women is technically successful and associated with short and medium-term improvement in quality of life as well as reduction in pelvic pain.

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Section: Resultsmentioning

confidence: 99%

“…1One case of intestinal injury during primary open trocar insertion immediately repaired through the umbilical incision (Clavien-Dindo grade 3) [18]. …”

Section: Resultsmentioning

confidence: 99%

“…Mini-cornuectomy [18]. The device was gently grasped and elevated using atraumatic forceps and monopolar scissors were then used to make a small, circular cornual incision.…”

Section: Methodsmentioning

confidence: 99%

Section: Commentmentioning

confidence: 99%

Section: Commentmentioning

confidence: 99%

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