No abstract

Prior reports of tubouterine anastomosis following Essure removal involve a cornual resection. We present a novel technique that does not require cornual resection. We also present the outcomes of three cases performed using this method. Design: Video and case series. Settings: A large academic medical center. Patients: The video is of a 30-year-old G2P2 with a history of pelvic pain for four years believed to be secondary to the Essure microinsert placed six years prior. The patient also desired restoration of fertility. The outcomes of two additional patients who underwent this procedure are also reported. Interventions: Bilateral laparoscopic Essure reversal. Measurements/Results: The video demonstrates laparoscopic Essure removal under hysteroscopic guidance followed by laparoscopic tubouterine reanastomosis along a tubal stent. Postoperative hysterosalpingogram demonstrated bilateral tubal patency. A total of three women have undergone this procedure without complications. All three have had postoperative confirmation of unilateral or bilateral tubal patency, however no pregnancies over 2 to 8 months of follow-up. Conclusions: Laparoscopic Essure reversal with restoration of tubal patency can be achieved without a cornual resection. More data is needed on this novel technique, including pregnancy outcomes.