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Robotic-assisted laparoscopic Essure removal: a novel surgical approach


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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Authors and Affiliations



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.

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Correspondence to William Nolan.

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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).

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  • Gynecology
  • Robotics
  • Pelvic Pain
  • Essure