Sterilization with the Essure Device was approved by the FDA in 2002. Because placement of the Essure Device can be performed in the physician’s office, this sterilization method has become an increasingly popular method for permanent birth control.
The Essure Device is composed of three separate components. The first component is a polyethylene plastic fiber that induces a fibrotic reaction (scarring) within the tube. The second component is a flexible stainless steel coil that holds the device within the fallopian tube, the third component is a paper-thin, fragile nickel-titanium outer coil. The Essure Device is placed into the interstitial portion of the fallopian tube (the segment of the tube that runs through the muscle of the uterus) and also into the proximal portion of the isthmic portion of the fallopian tube (the segment where the tube meets the uterus). The Essure Device is embedded or scarred into these segments of the fallopian tubes. This scarring of the fallopian tubes blocks the sperm from entering the tubes and prevents pregnancy.
ESSURE REVERSAL PROCEDURE
The Essure Reversal procedure is performed under general anesthesia through a two to four inch abdominal incision. Using the principles of microsurgery, the fallopian tube is incised about a half inch from its insertion into the uterus. Meticulous care is utilized to remove the Essure Device making sure that all three components of the device have been removed. Following this, the interstitial portion of the fallopian tube is dilated with lacrimal (tear duct) probes to ensure that this portion of the fallopian tube remains open. Then, continuing with microsurgery, the isthmic portion of the fallopian tube is reattached to the uterus. This procedure is then repeated on the other fallopian tube.
Following the completion of the contralateral fallopian tube, the small incision is closed and injected with a long lasting anesthetic agent. After observation in the recovery room, the patient is discharged home. Recovery is typically five to seven days.
The other method to perform an Essure Reversal is by performing a tubocornual implantation. In this method, an incision (hole) is made into the back of the uterus and the (interstitial portion of) fallopian tube is pulled into this incision. However, there is the risk of uterine rupture where the uterus tears apart during labor due to a weakness in the uterus (from the incision or hole). This complication can be fatal to the fetus and to the mother. This type of Essure Reversal method is not endorsed or performed by the Tubal Reversal Experts.
Is the Essure Reversal similar to the other tubal reversals that you perform?
While the principles of microsurgery are utilized for all our tubal reversals, the Essure Reversal is the most complicated procedure of all tubal reversals. The surgery involves two components; 1) removal of the Essure Device and 2) subsequent microsurgical anastomosis. Because of the additional time involved in this procedure it is more expensive than other types of tubal reversals.