Hitkari Jason A, Singh Sukhbir S, Shapiro Heather M, Leyland Nicholas
Department of Obstetrics and Gynaecology, Mt. Sinai Hospital, Toronto, Canada.
Fertil Steril. 2007 Dec;88(6):1663-6. doi: 10.1016/j.fertnstert.2007.01.050. Epub 2007 May 9.
To describe the use of Essure microinsert placement in patients with hydrosalpinges before IVF.
Retrospective case-series.
An advanced endoscopic practice within a university-affiliated teaching hospital.
PATIENT(S): Five women with unilateral or bilateral hydrosalpinges on transvaginal ultrasound, laparoscopy, or hysterosalpingogram who were planning further fertility therapy. In all patients, laparoscopy was felt to be relatively contraindicated because of previous extensive abdominopelvic surgery.
INTERVENTION(S): Hysteroscopic placement of the Essure microinsert in four patients under general anesthesia. One patient underwent fluoroscopically guided placement.
MAIN OUTCOME MEASURE(S): Placement rates and postoperative recovery, technical challenges in Essure placement, and results of subsequent treatment with IVF when available.
RESULT(S): Successful bilateral Essure placement was confirmed in two of five patients. Unilateral placement was achieved in two of five. There were no postoperative complications. No pregnancies have occurred thus far.
CONCLUSION(S): Hysteroscopic placement of the Essure microinsert is a minimally invasive option for proximal tubal occlusion. In patients requiring occlusion of hydrosalpinges before IVF and with contraindications to abdominal surgery, this technique may offer a safer alternative. Preoperative documentation of proximal tubal patency helps predict placement success. Further research into this unique clinical scenario is required.
描述在体外受精（IVF）前对输卵管积水患者使用Essure微插入物进行放置的情况。
回顾性病例系列研究。
一所大学附属医院内的高级内镜诊疗机构。
五名经阴道超声、腹腔镜检查或子宫输卵管造影显示单侧或双侧输卵管积水且计划进一步进行生育治疗的女性。所有患者因既往有广泛的腹部盆腔手术史，被认为相对禁忌进行腹腔镜检查。
在全身麻醉下，对四名患者进行宫腔镜下Essure微插入物放置。一名患者接受了荧光透视引导下的放置。
放置成功率、术后恢复情况、Essure放置的技术挑战以及后续IVF治疗的结果（如有）。
五名患者中有两名成功进行了双侧Essure放置。五名中有两名实现了单侧放置。无术后并发症。迄今为止未发生妊娠。
宫腔镜下放置Essure微插入物是近端输卵管阻塞的一种微创选择。对于IVF前需要阻塞输卵管积水且有腹部手术禁忌证的患者，该技术可能提供一种更安全的替代方法。术前记录近端输卵管通畅情况有助于预测放置成功率。需要对这种独特的临床情况进行进一步研究。
