Revel Ariel, Nadjary Michel, Shushan Asher
Department of Obstetrics and Gynecology, Hadassah University Hospital, Jerusalem, Israel.
Harefuah. 2008 Feb;147(2):107-10, 184.
Essure hysteroscopic sterilization is a minimally invasive, outpatient approach to female sterilization, which avoids the possible complications of laparoscopic sterilization. This procedure has been available since 2003 in both Europe and North America. We present our experience of the first 12 cases of the procedure performed in Israel.
Women who have completed their family planning were offered to consider Essure as their permanent contraception. The procedure was performed without anesthesia by the vaginoscopic technique at the hospital's outpatient clinic. Patients completed a questionnaire and were discharged immediately following the procedure. A follow-up checkup was completed after three months including three dimensional sonography, abdominal X-ray and occasional hysterosalpingogram.
Twelve patients participated in the pilot group at Hadassah. The average age was 40 years (34-45) and the average number of children was 5 (4-8). The average time for the procedure was under 8 minutes. Periostial adhesions required adhesiolysis prior to insertion of the device in one patient. All patients resumed their normal activity on the same day. Our patient satisfaction survey revealed that the procedure was associated with high satisfaction levels. Sonographic and radiographic studies confirmed the good placement of the device.
The Essure procedure was well tolerated by patients. The limitation is probably going to be the price of Essure, as this procedure is not covered by the 'health basket' in Israel.
Essure宫腔镜绝育术是一种微创的门诊女性绝育方法,可避免腹腔镜绝育术可能出现的并发症。自2003年以来,该手术在欧洲和北美均可实施。我们介绍了在以色列进行的首例12例该手术的经验。
已完成计划生育的女性可考虑将Essure作为其永久性避孕方法。该手术在医院门诊通过阴道镜技术在无麻醉的情况下进行。患者完成一份问卷,并在手术后立即出院。三个月后进行随访检查,包括三维超声检查、腹部X线检查以及偶尔的子宫输卵管造影。
12名患者参与了哈达萨医院的试点组。平均年龄为40岁(34 - 45岁),平均子女数为5个(4 - 8个)。手术平均时间不到8分钟。一名患者在植入装置前需要进行粘连松解以解除骨膜粘连。所有患者在同一天恢复正常活动。我们的患者满意度调查显示,该手术的满意度很高。超声和放射学研究证实了装置的良好放置。
患者对Essure手术耐受性良好。该手术的局限性可能在于其价格,因为在以色列“健康保险套餐”不涵盖此手术。