Removal of a Nexplanon® implant located in the biceps muscle using a combination of ultrasound and fluoroscopy guidance

Referral Center Experience With Nonpalpable Contraceptive Implant Removals

“…4 Referral to a specialty center with physicians who have expertise localizing and removing nonpalpable implants is essential. 9 Health care providers have described various advanced techniques to localize and remove nonpalpable implants 6,[9][10][11][12][13][14][15][16] ; however, the reports typically only include descriptions with a few patients and often involve costly resources such as interventional radiology, fluoroscopy, and removal in the operating room. 6 In the United Kingdom, the Faculty of Sexual and Reproductive Healthcare established a formal network of expert removal centers more than a decade ago 17 ; however, only in the past few years has a similar specialty removal network been developed in the United States.…”

Hormone-releasing contraceptive implants: our experience of complex removals using preoperative ultrasound

“…The recommended location of the insertion site is such that, while cosmetically hidden, the deeply placed implant puts the ulnar neurovascular bundle at significant risk. Studies have identified nonpalpable implants using intraoperative image intensifiers (X-rays) when a radioopaque implant is used [1], US preoperatively [2], US intraoperatively [5] and preoperative magnetic resonance imaging [6]. Invasive US-guided localization is also described, whereby a hook wire marker is placed near to the implant under US guidance [7].…”

“…Previous generations of device introducers were large bore needle and syringe systems. Following reports of deep implantation, introducers were modified with depthstops to prevent this complication, but these have not eradicated the problem [1][2][3]. When the patient requests removal, the implant should be easy to locate and remove under local anesthetic.…”

Combined hysteroscopy-laparoscopy approach for excision of pelvic nitinol fragment from Essure contraceptive device: Role of intraoperative fluoroscopy for uterine conservation

“…One case of successful Essure removal eight days after placement with fluoroscopy was reported in 2015 [ 6 ]. Fluoroscopy has been successfully used to remove larger non-permanent contraceptive implants imbedded in soft tissue of an extremity [ 10 ], but the procedure has not been standardized for removal of Essure devices in the abdomen or pelvis.…”