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Essure Coil Removal
Increasing Chance of Intact Removal

Essure-coil-removal-in-middle

Dissection begins in the most superficial area where the device is observed.

Essure coil removal was previously performed at our facility by applying direct traction on the Essure micro-inserts.

Although this was simpler and faster than the procedure we now perform, manual traction on the coils frequently resulted in coil breakage and increased the chance of leaving residual Essure fragments.

We now perform a precise en bloc dissection of each Essure micro-insert.

Now our Essure coil removal surgeries are more likely to result in complete removal of each Essure micro-insert as well as any surrounding fibrosis.

Essure coil removal: Dissect rather than pull

Essure-coil-removal-hemostasis

Dissection starts in middle of coil and continues medially. Note the absence of blood in the area of dissection.

After adequate uterine tourniquet application, Essure coil removal can be performed with sharp dissection directly on the anti-mesenteric portion of the coil.

We perform sharp dissection with a #11 blade tip scalpel. This blade size provides more precise dissection immediately on and alongside the micro-inserts.

Dissection for Essure coil removal begins in the mid-to-distal portion of the Essure micro-insert device in the area of interstitial tube which is the most superficial. Often this is the area where the Essure devices are the most visible.

Using sharp dissection the Essure micro-insert device is followed medially as it travels through the interstitial myometrium and into the uterine cavity. Suction irrigation is performed during the dissection to maintain visibility in the area of dissection by removing any residual venous blood.

Essure-coil-removal-medial-aspect

Proximal ends of both inner and outer coil have been identified within the myometrium.

It is during the dissection of the interstitial segment of tube that awareness of anatomic variations becomes important. The Essure micro-insert can travel in different directions, at different depths, and can dive towards the endometrial cavity at different areas within the myometrium.

Occasionally the depth of the coil is superficial and occasionally the depth of the coil is deeper.

As dissection is performed it is helpful to stabilize the Essure micro-insert with a hand-held forceps (i.e. Debakey) to minimize rolling of the device. We stay on top of the device as much as possible and the purpose of this dissection is to track the micro-inserts into the uterine cavity.

Essure coil removal: En bloc removal

en-bloc-dissection-essure-devices-minimizes-essure-device-fracture

En bloc dissection of both Essure micro-inserts. Each device is intact and surrounded by tubal muscularis.

Once the proximal tip of the Essure device is identified then the medial most portion of the intra-tubal insert can be grasped and elevated with hand-held forceps.

The proximal tip of the micro-insert can be retracted laterally to allow more exposure underneath the device. Dissection can then be performed along the mesenteric side of the device towards the distal end of the intratubal micro-insert.

If necessary we will utilize electrosurgery at this time to provide additional hemostasis because the risk of coil fracture is minimal when the entire coil is visualized and the more difficult medial dissection has been completed.

The entire device can then be removed intact an en bloc with adjacent tubal muscularis and surrounding fibrosis. We now feel en bloc dissection is the most precise surgical technique that increases the chance of intact micro-insert removal.

30 thoughts on “Essure Coil Removal: Advice On How To Avoid Leaving Fragments”

  1. Maria says:

    I got Essure done back in 2014 and I’ve had heavy periods and always feel bloated and side pains I have called many doctors asking if there is a Essure reversal I want to have more children . I need help finding someone to do the Essure reversal and have more babies . Thank u hope to hear from y’all soon .

    1. Dr. Monteith says:

      Maria
      We specialize in Essure reversal and Essure removal surgery. We can reverse Essure and give you the chance of pregnancy….or we can remove Essure and leave your tubes closed. The chance of pregnancy after Essure reversal is about 40%.

      More information: Essure reversal testimonials

      The cost is the same $7,500. We are located in Raleigh, North Carolina.

      No other clinic or doctor has the experience we do. The chance of pregnancy after Essure reversal is about 40%. If you are having symptoms that started soon after Essure most patients report improvement after removal of the devices. We do have a surgery prepayment plan.

      More information: Successful Essure reversal with Dr Monteith

      We charge a total of $7,500 for Essure reversal/removal plus $125 to schedule surgery. If you use our prepayment plan then you can contribute any amount as you are able but you must have the surgery paid for by three years. We do work with two financing companies and we do have a prepayment plan.

      The following link will answer most of your questions about reversal. This is the MOST HELPFUL INFORMATION to read when considering reversal at our office. Each question has a link to more information about the question: Frequently asked questions about tubal reversal

  2. Karen says:

    Are there still risks of leaving PET fibers behind with your removal technique?

    1. Dr. Monteith says:

      Karen
      We dont leave the PET fibers behind. We perform an en bloc dissection and remove the coil intact with the surrounding scar tissue.

  3. Susie Antaya says:

    My daughter has suffered with this device since 2009. Blood clots, heavy, heavy bleeding. Joint and extreme back pain. Rashes and her hair is falling out. Please help us…

    1. Dr. Monteith says:

      We can remove the coils and most patients report improvement. Please give our office a call at (919)968-4656 and we can answer any questions you may have about Essure coil removal surgery at our center.

  4. Jessica says:

    My doctor called me tonight and told me my essure perforated my endometrium. I have had the essure for 6 yrs and according to X-rays from back then my tubes are blocked. I had heavy/long periods since getting the essure but just started seeing a new doctor who wanted to see why rather than just doing BC to make them more regular. I live in Iowa so insurance probably won’t allow me to travel to get the coils removed. What are my options for removal and how significant/likely is it that the essure is causing my heavy periods?

    1. Dr. Monteith says:

      Jessica
      We have many patients like you and have seen some unique Essure complications that can cause heavier periods and uterine cramping. We can remove the coils without performing a hysterectomy. We are unable to accept insurance for tubal reversal or Essure related surgery. Patients will pay directly for their surgery and will often get partial reimbursement from their insurance companies. Please call our office at (919)968-4656 if we can be of assistance.

  5. tiffany says:

    What are the risk factors? And the down time?

    1. Dr. Monteith says:

      The risks are minimal and most patients can return to light duty within 10 days of surgery. Please call us at (919)968-4656 if you need more detailed information.

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