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      NUEVO MÉTODO DE ESTERILIZACIÓN AMBULATORIA Y PERMANENTE CON TÉCNICA HISTEROSCÓPICA, ESSURE

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          Abstract

          Objetivo: Presentamos nuestra experiencia en la inserción de un nuevo método de esterilización permanente vía histeroscópica, Essure. Se revisa el procedimiento de inserción, complicaciones, tolerancia, grado de satisfacción y aceptación de usuaria. Método: Entre enero y febrero de 2005 se realizaron 5 esterilizaciones con Essure en la Unidad de Ginecología y Obstetricia de Clínica Las Condes. Resultados: Se colocó el dispositivo en ambas trompas exitosamente en todas las pacientes. Rango de tiempo operatorio: 10-30 minutos. No hubo complicaciones intraoperatorias. Todas expresaron buena tolerancia y un alto grado de satisfacción frente al procedimiento de inserción histeroscópico. Lo recomendarían por su rapidez, carácter ambulatorio y ausencia de dolor. Durante el postoperatorio un caso presentó metrorragia leve y algia pélvica moderada. Conclusiones: Nuestra primera experiencia en la inserción del dispositivo intra tubario mostró ser un procedimiento bien tolerado y con buena aceptación por las pacientes

          Translated abstract

          Objective: We presented our experience in Essure insertion, a new hysteroscopic permanent sterilization method. We reviewed insertion procedure, complications, degree of tolerance and acceptance by user. Method: Between January and February 2005 five sterilizations cases with Essure were made in Las Condes Clinic. Results: The device in both tubes in all women was placed. Operative time was between 10 and 30 minutes. Intraoperative complications did not appear. All patients expressed very good tolerance and a high degree of satisfaction with insertion procedure. The reason because they would recommend it was: rapidity, ambulatory and absence of pain. During postoperative time one case presented weighs uterus bleeding and moderate pain. Conclusion: Our first experience in hysteroscopic intra Fallopian tube device insertion showed a procedure with very good tolerance and acceptance by the patients

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          Most cited references26

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          Hysteroscopic sterilization using a micro-insert device: results of a multicentre Phase II study.

          Unlike laparoscopic surgery for interval tubal sterilization, a hysteroscopic approach obviates surgical incision and requires only local anaesthesia or intravenous sedation. The safety, tolerability and efficacy of an hysteroscopically placed micro-insert device was evaluated. A cohort of 227 previously fertile women participated in this prospective international multicentre trial. Micro-inserts were placed bilaterally into the proximal Fallopian tube lumens under hysteroscopic visualization in outpatient procedures. Successful bilateral micro-insert placement was achieved in 88% of women. The majority of women reported that intraprocedural pain was less than or equal to that expected, and 90% rated tolerance of the device placement procedure as good to excellent. Most women could be discharged in an ambulatory state within 1-2 h. Adverse events occurred in 7% of the women, but none was serious. Correct device placement was confirmed in 97% of cases at 3 months. Over 24 months follow-up, 98% of study participants rated their tolerance of the micro-insert as very good to excellent. After 6015 woman-months of exposure to intercourse, no pregnancies have been recorded. Hysteroscopic sterilization resulted in rapid patient recovery without unacceptable post-procedure pain, as well as high long-term patient tolerability, satisfaction and effective permanent contraception.
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            Tissue response to the STOP microcoil transcervical permanent contraceptive device: results from a prehysterectomy study.

            The present study examines the safety, effectiveness, and local tissue response for a new transcervical fallopian tube permanent contraceptive device, the STOP device (Conceptus, Inc., San Carlos, CA). Nonrandomized prospective evaluation of tubal occlusion and histologic response. Inpatient, university and university-affiliated medical centers in the United States and Mexico. Premenopausal and perimenopausal women with benign indications for hysterectomy who were able to defer their hysterectomy for 1 to 13 weeks. A transcervically placed microcoil (STOP device) was inserted into the fallopian tubes of women who were scheduled for hysterectomy, and the device was worn for 1 to 12 weeks. At hysterectomy, hysterosalpingography was done to determine tubal occlusion; subsequently, the tubes containing the STOP devices were processed, sectioned, and evaluated to determine the histologic response. Ability to place a device and evaluate tubal occlusion and tissue response. Devices were placed in 33 women, representing 57 tubes; the women wore the devices from 1 day to 30 weeks. Histology on 27 women (47 tubes) showed an acute inflammatory and fibrotic response in the short term that, over time, became a chronic inflammatory response with extensive fibrosis. The localized tissue response and notable absence of any normal tubal architecture in the segment of the fallopian tube containing the STOP device supports the postulated mechanisms of action of the device. Prehysterectomy study findings suggest the usefulness of the STOP device for pregnancy prevention, this is being evaluated in long-term safety and effectiveness studies.
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              Essure: a new device for hysteroscopic tubal sterilization in an outpatient setting.

              To evaluate the results of hysteroscopic placement of an intratubal device for permanent birth control in 85 women in an outpatient setting. Prospective, observational study. Private university hospital. Eighty-five premenopausal women who asked for tubal sterilization by hysteroscopy between July 2002 and July 2003. Hysteroscopic placement of titanium-dacron intratubal devices in an outpatient setting. Procedure feasibility without anesthesia, success rate of device implantation, patient satisfaction, and confirmation of correct placement. Successful placement was achieved in 81 patients (95%). Mean time elapsed between the start of hysteroscopy, placement of devices, and removal of optics was 9 minutes (range, 1-35 minutes). No intraoperative or postoperative complications were detected. Of 81 patients, 75 (93%) had abdominal x-ray performed at the third month; bilateral correct placement was confirmed in all of them. Essure is a safe, effective, and minimally aggressive procedure with satisfactory patient acceptance that does not require anesthesia or hospitalization. It seems to be a good alternative to laparoscopic tubal sterilization.
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                Author and article information

                Journal
                rchog
                Revista chilena de obstetricia y ginecología
                Rev. chil. obstet. ginecol.
                Sociedad Chilena de Obstetricia y Ginecología (Santiago, , Chile )
                0048-766X
                0717-7526
                2005
                : 70
                : 1
                : 28-32
                Affiliations
                [01] orgnameClínica Las Condes orgdiv1Departamento de Ginecología y Obstetricia orgdiv2Unidad de Ginecología Chile
                Article
                S0717-75262005000100008 S0717-7526(05)07000100008
                10.4067/S0717-75262005000100008
                0cb643fa-acaf-4861-8a0f-23799c9e1887

                This work is licensed under a Creative Commons Attribution 4.0 International License.

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                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 19, Pages: 5
                Product

                SciELO Chile

                Categories
                Caso Clínico

                esterilización ambulatoria,histeroscopía,Permanent sterilization,ambulatory sterilization,dispositivo intra tubario,Esterilización permanente,intra Fallopian tube device,hysteroscopy

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