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Myometrial Insertion of Essure® Mirco-Insert

Jeffrey J Woo, Barbara E Simpson, Dale W Stovall

Complications arising from hysteroscopically-placed intratubal micro-insert devices are uncommon. Partial and complete perforations occur in approximately 0.9% to 2.6% while movement of the micro-insert device within the abdomen is even more rare. In this case report, the initial placement of the micro-insert device was uncomplicated, but concerns of cornual or fallopian tube perforation were apparent on the confirmation hysterosalpingogram (HSG) when free tubal spill was appreciated. After a succession of hysteroscopic and laparoscopic evaluations, and a final specimen dissection, the micro-insert device was found penetrating superior to the tubal ostia and embedded in the myometrium.