Management of perforated essure with migration into small and large bowel mesentery

J Minim Invasive Gynecol. 2015 Mar-Apr;22(3):504-8. doi: 10.1016/j.jmig.2014.11.003. Epub 2014 Nov 11.

Abstract

The Essure permanent birth control system (Conceptus Inc, San Carlos, CA) is currently the only Food and Drug Administration-approved hysteroscopic sterilization method and has been widely accepted as a safe and effective procedure. We present a rare case of tubal perforation, coil fragmentation, and distal migration into small and large bowel mesentery 8 days after the insertion of the Essure device. We describe the successful management of this complication using laparoscopy and intraoperative fluoroscopy. Providers using Essure must be aware of the possibility of fragmentation of the Essure coils. Intraoperative imaging, ideally fluoroscopy, should be strongly considered in the management of Essure migration to ensure localization and full retrieval of Essure material.

Keywords: Essure; Fluoroscopy; Laparoscopy; Tubal perforation.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Fallopian Tubes* / diagnostic imaging
  • Fallopian Tubes* / injuries
  • Fallopian Tubes* / surgery
  • Female
  • Fluoroscopy / methods
  • Humans
  • Intraoperative Care / methods
  • Intrauterine Device Migration*
  • Intrauterine Devices / adverse effects
  • Laparoscopy / methods*
  • Mesentery / diagnostic imaging*
  • Rupture
  • Salpingectomy / methods
  • Sterilization, Tubal* / adverse effects
  • Sterilization, Tubal* / instrumentation
  • Sterilization, Tubal* / methods
  • Treatment Outcome
  • Ultrasonography