LAUSR

STUDY OBJECTIVE The aim of this study was to evaluate the feasibility, efficacy, and morbidity of Essure® device removal via laparoscopic en bloc salpingectomy-cornuectomy resection (LSC) and the utility of confirmation of complete removal with an intraoperative X-ray of the removed specimen (IX-S). DESIGN Retrospective observational cohort study. SETTING Accademic Hospitals of La Conception, Marseille and Arnaud-de-Villeneuve, Montpellier, France. PATIENTS Women who were not seeking future fertility seeking Essure® device removal by salpingectomy, from February 2017 to August 2018. INTERVENTIONS All women underwent LSC. An IX-S was performed to confirm complete Essure® device removal. In the case of an unsatisfactory IX-S, an intraoperative pelvic X-ray control of the patient (IX-P) was performed. If IX-P diagnosed residual Essure® fragments, an additional resection was performed, and the removed tissue was checked by IX-S. MEASUREMENTS AND MAIN RESULTS We included 72 women, and a total of 140 Essure® devices were removed. The IX-S confirmed complete Essure® device removal in 131/140 (93.6%) cases in 63/72 (87.5%) women. Out of the 9 women with unsatisfactory IX-S, 6 had no residual Essure® fragments at IX-P, and Essure® device removal was considered complete. Three women had a persistent Essure® fragment at IX-P: an additional resection allowed complete removal in 2 cases and resulted in failure in 1/140 case (0.7%). There were 2/72 (2.8%) intraoperative complications and 4/72 (5.6%) postoperative grade 1 complications according to Clavien and Dindo classification. CONCLUSION Essure® device removal by LSC appears to be an effective and safe procedure. IX-S is a useful method to evaluate whether the removal of Essure® device is complete during an LSC procedure.