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Robotic-assisted laparoscopic Essure removal: a novel surgical approach

Abstract

Primary objective was to evaluate safety and feasibility of robotic-assisted Essure removal while describing the procedure. Secondary objective was to assess improvement of symptoms post-operatively. The design was retrospective cohort study. Patients included were those who underwent robotic-assisted Essure removal between June, 2015 and December, 2020 for symptomatic relief. Interventions are robotic-assisted laparoscopic removal of Essure devices. A retrospective chart review was conducted. Phone survey of pain scores and quality-of-life ratings were performed. Twenty-one women underwent robotic-assisted removal of Essure devices. Two cases were excluded from analysis due to concomitant procedures. All devices were removed intact (19/19). The mean time from placement to removal was 5.3 years. Safety and feasibility were demonstrated, mean operating time was 43.1 ± 12 min, mean length of stay (LOS) was 11 h, and no complications occurred. Mean pain scores (0–10) improved from 8.5 before surgery to 0.75 at 1 month after surgery (p < 0.005). Mean Quality-of-Life (QOL) scores (0–7) improved from 5.9 prior to surgery to 1.5 at 1 month after surgery (p < 0.005). To our knowledge, this is the first report of the use of robotic assistance for Essure removal. Robotic-assisted laparoscopic Essure removal appears safe, feasible, and potentially superior to other surgical approaches. Despite discontinuation of the device in 2018, Essure removal is likely to remain needed. Robotic-assisted laparoscopic Essure removal appears effective in treating pain and various other symptoms attributed to Essure devices.

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References

  1. AAGL Advisory Statement (2016) Essure hysteroscopic sterilization. J Minim Invasive Gynecol 23(5):658–659. https://doi.org/10.1016/j.jmig.2016.06.005

    Article  Google Scholar 

  2. Maassen LW et al (2019) Removal of Essure sterilization devices: a retrospective cohort study in the Netherlands. JMIG 26(6):1056–1062. https://doi.org/10.1016/j.jmig.2018.10.009

    Article  Google Scholar 

  3. Brito LGO et al (2015) Essure surgical removal and subsequent symptom resolution: case series and follow-up survey. JMIG 22(5):910–913. https://doi.org/10.1016/j.jmig.2015.03.018

    Article  Google Scholar 

  4. Clark NV et al (2017) Essure removal for the treatment of device-attributed symptoms: an expanded case series and follow-up survey. JMIG 24(6):971–976. https://doi.org/10.1016/j.jmig.2017.05.015

    Article  Google Scholar 

  5. Lannon BM, Lee S-Y (2007) Techniques for removal of the Essure* hysteroscopic tubal occlusion device. Fertil Steril 88(2):497.e13-497.e14. https://doi.org/10.1016/j.fertnstert.2006.11.072

    Article  Google Scholar 

  6. Lazorwitz A, Tocce K (2017) A case series of removal of nickel-titanium sterilization microinserts from the uterine cornua using laparoscopic electrocautery for salpingectomy. Contraception 96(2):96–98. https://doi.org/10.1016/j.contraception.2017.06.002

    Article  PubMed  Google Scholar 

  7. Chene G et al (2019) Quality of life after laparoscopic removal of Essure® sterilization devices. EJOGR X(3):1–6. doi:https://doi.org/10.1016/j.eurox.2019.100054.

  8. Albright CM et al (2013) Surgical aspects of removal of Essure microinsert. Contraception 88(3):334–336. https://doi.org/10.1016/j.contraception.2012.11.020

    Article  PubMed  Google Scholar 

  9. Johal T et al (2018) Laparoscopic salpingectomy and removal of Essure hysteroscopic sterilisation device: a case series. Eur J Contracept Reprod Health Care 23(3):227–230. https://doi.org/10.1080/13625187.2018.1471131

    CAS  Article  PubMed  Google Scholar 

  10. Thiel L et al. (2017) Laparoscopic cornuectomy as a technique for removal of Essure microinserts. JMIG, US National Library of Medicine. www.ncbi.nlm.nih.gov/pubmed/27422719.

  11. Mahmoud M (2015) Laparoscopic removal of Essure microinserts. JMIG 22(6). doi:https://doi.org/10.1016/j.jmig.2015.08.428.

  12. Miquel L et al (2020) Laparoscopic Essure® device removal by en bloc salpingectomy-cornuectomy with intraoperative x-ray checking: a retrospective cohort study. JMIG 27(3):697–703. https://doi.org/10.1016/j.jmig.2019.06.006

    Article  Google Scholar 

  13. Casey J et al (2016) Outcomes of laparoscopic removal of the Essure sterilization device for pelvic pain: a case series. Contraception 94(2):190–192. https://doi.org/10.1016/j.contraception.2016.03.017

    Article  PubMed  Google Scholar 

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Funding

Unfunded resident research.

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Authors

Contributions

Conceptualization: AG, WN, and HO; methodology: WN; formal analysis and investigation: WN and LG; writing—original draft preparation: WN; writing—review and editing: AG, WN, and HO; funding acquisition: none; resources: none; supervision: AG.

Corresponding author

Correspondence to William Nolan.

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None reported.

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This study was reviewed and approved by Institutional Review Board at Catholic Health System, Buffalo, New York.

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Patients were consented for collection of medical information upon hospitalization. Consent to participate in interview was obtained before proceeding with patient interviews. Authors hereby give consent to publication of this manuscript.

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Nolan, W., Ohaeri, H., Georger, L. et al. Robotic-assisted laparoscopic Essure removal: a novel surgical approach. J Robotic Surg 15, 781–784 (2021). https://doi.org/10.1007/s11701-020-01176-2

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  • DOI: https://doi.org/10.1007/s11701-020-01176-2

Keywords

  • Gynecology
  • Robotics
  • Pelvic Pain
  • Essure