A Novel Technique for Essure Reversal

BACKGROUND AND OBJECTIVES: An increasing number of women are seeking removal of the Essure sterilization device due to symptoms including pelvic pain, abnormal bleeding, and allergic reaction. A fraction of these women also desire a future pregnancy and request sterilization reversal at the time of device removal. We present a novel technique for Essure reversal in addition to our experience with three cases. METHODS: Simultaneous laparoscopy and hysteroscopy is used to remove the device followed by laparoscopic reimplantation of the distal fallopian tube to the uterine fundus. A video of our method is included and the outcomes of three patients reported. RESULTS: Three women underwent laparoscopic Essure reversal for device-attributed symptoms and desire to restore fertility between 2017 and 2018. All procedures were uncomplicated with restoration of tubal patency in one or both fallopian tubes on follow-up hysterosalpingogram. Over a period of 4 to 10 months of followup, no pregnancies have been reported. CONCLUSION: Essure reversal is a feasible technique for removing the device and restoring tubal patency; however, more data are needed on pregnancy outcomes following this novel procedure.