1
|
Bouillon K, Bertrand M, Bader G, Lucot JP, Dray-Spira R, Zureik M. Association of Hysteroscopic vs Laparoscopic Sterilization With Procedural, Gynecological, and Medical Outcomes. JAMA 2018; 319:375-387. [PMID: 29362796 PMCID: PMC5833563 DOI: 10.1001/jama.2017.21269] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
IMPORTANCE Safety of hysteroscopic sterilization has been recently questioned following reports of general symptoms such as allergy, tiredness, and depression in addition to associated gynecological results such as pelvic pain, perforation of fallopian tubes or uterus, and unwanted pregnancy. OBJECTIVE To compare the risk of reported adverse events between hysteroscopic and laparoscopic sterilization. DESIGN, SETTING, AND PARTICIPANTS French nationwide cohort study using the national hospital discharge database linked to the health insurance claims database. Women aged 30 to 54 years receiving a first hysteroscopic or laparoscopic sterilization between 2010 and 2014 were included and were followed up through December 2015. EXPOSURES Hysteroscopic sterilization vs laparoscopic sterilization. MAIN OUTCOMES AND MEASURES Risks of procedural complications (surgical and medical) and of gynecological (sterilization failure that includes salpingectomy, second sterilization procedure, or pregnancy; pregnancy; reoperation) and medical outcomes (all types of allergy; autoimmune diseases; thyroid disorder; use of analgesics, antimigraines, antidepressants, benzodiazepines; outpatient visits; sickness absence; suicide attempts; death) that occurred within 1 and 3 years after sterilization were compared using inverse probability of treatment-weighted Cox models. RESULTS Of the 105 357 women included (95.5% of eligible participants; mean age, 41.3 years [SD, 3.7 years]), 71 303 (67.7% ) underwent hysteroscopic sterilization, and 34 054 (32.3%) underwent laparoscopic sterilization. During the hospitalization for sterilization, risk of surgical complications for hysteroscopic sterilization was lower: 0.13% for hysteroscopic sterilization vs 0.78% for laparoscopic sterilization (adjusted risk difference [RD], -0.64; 95% CI, -0.67 to -0.60) and was lower for medical complications: 0.06% vs 0.11% (adjusted RD, -0.05; 95% CI, -0.08 to -0.01). During the first year after sterilization, 4.83% of women who underwent hysteroscopic sterilization had a higher risk of sterilization failure than the 0.69% who underwent laparoscopic sterilization (adjusted hazard ratio [HR], 7.11; 95% CI, 5.92 to 8.54; adjusted RD, 4.23 per 100 person-years; 95% CI, 3.40 to 5.22). Additionally, 5.65% of women who underwent hysteroscopic sterilization required gynecological reoperation vs 1.76% of women who underwent laparoscopic sterilization (adjusted HR, 3.26; 95% CI, 2.90 to 3.67; adjusted RD, 4.63 per 100 person-years; 95% CI, 3.38 to 4.75); these differences persisted after 3 years, although attenuated. Hysteroscopic sterilization was associated with a lower risk of pregnancy within the first year of the procedure but was not significantly associated with a difference in risk of pregnancy by the third year (adjusted HR, 1.04; 95% CI, 0.83-1.30; adjusted RD, 0.01 per 100 person-years; 95% CI, -0.04 to 0.07). Risks of medical outcomes were not significantly increased with hysteroscopic sterilization compared with laparoscopic sterilization. CONCLUSIONS AND RELEVANCE Among women undergoing first sterilization, the use of hysteroscopic sterilization was significantly associated with higher risk of gynecological complications over 1 year and over 3 years than was laparoscopic sterilization. Risk of medical outcomes was not significantly increased over 1 year or over 3 years. These findings do not support increased medical risks associated with hysteroscopic sterilization.
Collapse
Affiliation(s)
- Kim Bouillon
- Department of Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety (ANSM), Saint-Denis, France
| | - Marion Bertrand
- Department of Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety (ANSM), Saint-Denis, France
| | - Georges Bader
- Department of Obstetrics and Gynecology and Reproductive Medicine, Poissy Hospital, Poissy, France
| | - Jean-Philippe Lucot
- Department of Gynecology and Obstetrics, Centre Hospitalier de Bethune, Bethune, France
| | - Rosemary Dray-Spira
- Department of Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety (ANSM), Saint-Denis, France
| | - Mahmoud Zureik
- Department of Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety (ANSM), Saint-Denis, France
- University Versailles St-Quentin-en-Yvelines, Montigny le Bretonneux, France
| |
Collapse
|
2
|
[Can we still afford to put Essure ®?]. ACTA ACUST UNITED AC 2017; 45:127-128. [PMID: 28259704 DOI: 10.1016/j.gofs.2017.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Indexed: 11/21/2022]
|
3
|
|
4
|
Frietze G, Leyser-Whalen O, Rahman M, Rouhani M, Berenson AB. A Meta-Analysis of Bilateral Essure ® Procedural Placement Success Rates on First Attempt. J Gynecol Surg 2015; 31:308-317. [PMID: 26633935 DOI: 10.1089/gyn.2015.0054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: The Essure® (Bayer HealthCare Pharmaceuticals, Leverkusen, Germany) female sterilization procedure entails using a hysteroscope to guide a microinsert into the Fallopian tube openings. Failed placement can lead to patient dissatisfaction, repeat procedures, unintended or ectopic pregnancy, perforation of internal organs, or need for subsequent medical interventions. Additional interventions increase women's health risks, and costs for patients and the health care industry. Demonstrated successful placement rates are 63%-100%. To date, there have not been any systematic analyses of variables associated with placement rates. Objectives: The aims of this review were: (1) to estimate the average rate of successful bilateral Essure microinsert placement on first attempt; and (2) to identify variables associated with successful placement. Materials and Methods: A meta-analysis was conducted on 64 published studies and 19 variables. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, all published studies between November 2001 and February 2015 were reviewed. The studies were taken from from PubMed and Google Scholar, and by using the the "snowball" method that reported variables associated with successful bilateral Essure placement rates. Results: The weighted average rate of successful bilateral microinsert placement on first attempt was 92% (0.92 [95% confidence interval: 0.904-0.931]). Variables associated with successful placements were: (1) newer device models; (2) higher body mass index; and (3) a higher percent of patients who received local anesthesia. Conclusions: The data gathered for this review indicate that the highest bilateral success rates may be obtained by utilizing the newest Essure device model with local anesthesia in heavier patients. More standardized data reporting in published Essure studies is recommended. (J GYNECOL SURG 31:308).
Collapse
Affiliation(s)
- Gabriel Frietze
- Department of Psychology, The University of Texas at El Paso , El Paso, TX
| | - Ophra Leyser-Whalen
- Department of Sociology and Anthropology, The University of Texas at El Paso , El Paso, TX
| | - Mahbubur Rahman
- Center for Interdisciplinary Research in Women's Health, The University of Texas Medical Branch , Galveston, TX
| | - Mahta Rouhani
- Center for Interdisciplinary Research in Women's Health, The University of Texas Medical Branch , Galveston, TX
| | - Abbey B Berenson
- Center for Interdisciplinary Research in Women's Health, The University of Texas Medical Branch , Galveston, TX
| |
Collapse
|
5
|
la Chapelle CF, Veersema S, Brölmann HA, Jansen FW. Effectiveness and feasibility of hysteroscopic sterilization techniques: a systematic review and meta-analysis. Fertil Steril 2015; 103:1516-25.e1-3. [DOI: 10.1016/j.fertnstert.2015.03.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 03/12/2015] [Accepted: 03/12/2015] [Indexed: 10/23/2022]
|
6
|
Occlusion d’hydrosalpinx à l’aide de micro-implants posés par hystéroscopie chez des patientes sous immunosuppresseurs. ACTA ACUST UNITED AC 2015; 43:397-8. [DOI: 10.1016/j.gyobfe.2015.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 10/09/2014] [Indexed: 11/18/2022]
|
7
|
Rufenacht E, Roesch M, Courjon M, Maillet R, Ramanah R, Riethmuller D. [Evaluation of satisfaction after hysteroscopic tubal ligation. About a study from the CHU of Besançon]. ACTA ACUST UNITED AC 2015; 43:176-80. [PMID: 25605508 DOI: 10.1016/j.gyobfe.2014.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 12/17/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The Essure(®) system is a hysteroscopic sterilization method. The purpose of our study was to retrospectively evaluate the sterilization procedure with Essure(®) devices without anesthesia. PATIENTS AND METHODS The descriptive study included all tubal sterilizations with Essure(®) devices performed without anesthesia, with MEOPA, from January 1st, 2013 till February 28th, 2014 in the CHU of Besançon. The evaluation of the global satisfaction of the patients was collected by telephone survey. RESULTS A hundred and forty-three patients benefited from Essure(®) without anesthesia during the period of study in the CHU of Besançon and among them, 120 patients answered the telephone survey questionnaire. The average age was of 41.3 years. As regards the satisfaction and the tolerance, 89.2% of the patients declared to be globally satisfied by this procedure and 95.8% would recommend it to a friend. Indeed, 66.6% of the patients declared to have felt no pain or moderate pain. Furthermore, the MEOPA was well tolerated at 79.9% of the patients. As regards the procedure of Essure(®) inserts without anesthesia the rate of failure was 9.2% and at 3 months the radiological control was satisfactory in 94.5% of the patients. DISCUSSION AND CONCLUSION The tubaire sterilization by implants Essure(®) is a fast and effective procedure. Our study shows, that at present, this technique can be realized without anesthesia, during a dedicated consultation, with an important rate of global satisfaction of the patients. It thus allows to decrease the number of hospitalization in ambulatory surgery and to decrease the cost of this intervention.
Collapse
Affiliation(s)
- E Rufenacht
- Pôle mère-femme, CHRU de Besançon, 3, boulevard Fleming, 25000 Besançon, France
| | - M Roesch
- Pôle mère-femme, CHRU de Besançon, 3, boulevard Fleming, 25000 Besançon, France
| | - M Courjon
- Pôle mère-femme, CHRU de Besançon, 3, boulevard Fleming, 25000 Besançon, France
| | - R Maillet
- Pôle mère-femme, CHRU de Besançon, 3, boulevard Fleming, 25000 Besançon, France
| | - R Ramanah
- Pôle mère-femme, CHRU de Besançon, 3, boulevard Fleming, 25000 Besançon, France
| | - D Riethmuller
- Pôle mère-femme, CHRU de Besançon, 3, boulevard Fleming, 25000 Besançon, France.
| |
Collapse
|
8
|
Fernandez H, Legendre G, Blein C, Lamarsalle L, Panel P. Tubal sterilization: pregnancy rates after hysteroscopic versus laparoscopic sterilization in France, 2006-2010. Eur J Obstet Gynecol Reprod Biol 2014; 180:133-7. [PMID: 24993770 DOI: 10.1016/j.ejogrb.2014.04.043] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 04/28/2014] [Accepted: 04/30/2014] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To compare the rates of pregnancy among women who underwent Essure hysteroscopic sterilization versus tubal ligation in France between 2006 and 2010. STUDY DESIGN Retrospective cohort study. SETTING Hospital care in France (nationwide). Anonymised database of all hospital discharge summaries in France. PATIENTS Recruitment was based on procedure codes in the national database of hospital discharge summaries. The study included all women who underwent tubal sterilization by Essure microinserts or by tubal ligation and subsequently were hospitalised either for all unexpected pregnancies related diagnosis (e.g., miscarriage, legal abortion, or delivery) or for pregnancies following reversal microsurgery or invitro fertilization (IVF) treatment. MEASUREMENTS AND MAIN RESULTS During the study period, French hospitals performed 109,277 tubal sterilization procedures: 39,169 Essure sterilizations and 70,108 laparoscopic tubal ligations. The respective indication of both techniques depended on the surgeons' skill. The median age of the two populations was similar, 41 years (range 28-52) for Essure patients and 40 years (range 27-54) for those undergoing tubal ligation (p=0.42). A Cox model has been performed. Following sterilization, after adjustment on age Essure patients became pregnant at a significantly lower rate than laparoscopic ligation patients 0.36% versus 0.46%, respectively (HR=0.62 (040-096)), and their pregnancy rate of post-sterilization procedure was significantly lower (reversal microsurgeries: 0.02% versus 0.19% (p<0.001), IVF treatment: 0.08% versus 0.27%) (p<0.001). The pregnancy rates after IVF were 12.5% and 5.35%, respectively, and 0% and 11.36% after tubal repair. CONCLUSION This nationwide study of tubal sterilization demonstrates that Essure was associated with lower rates of pregnancy versus tubal ligation.
Collapse
Affiliation(s)
- H Fernandez
- AP-HP, Department of Obstetrics and Gynecology, Hôpital Bicêtre, 78 rue du Général Leclerc, Le Kremlin Bicêtre, 94270, France; CESP-INSERM U1018, 82 rue du Général Leclerc, Le Kremlin Bicêtre, 94276, France; Université Paris Sud, 63 rue Gabriel Péri, Le Kremlin Bicêtre, 94270, France.
| | - G Legendre
- AP-HP, Department of Obstetrics and Gynecology, Hôpital Bicêtre, 78 rue du Général Leclerc, Le Kremlin Bicêtre, 94270, France; Université Paris Sud, 63 rue Gabriel Péri, Le Kremlin Bicêtre, 94270, France
| | - C Blein
- Heva-Health Evaluation, 186 avenue Thiers, Lyon, France
| | - L Lamarsalle
- Heva-Health Evaluation, 186 avenue Thiers, Lyon, France
| | - P Panel
- Department of Obstetrics and Gynecology, Centre Hospitalier de Versailles, Versailles, France
| |
Collapse
|
9
|
Levy-Zauberman Y, Legendre G, Nazac A, Faivre E, Deffieux X, Fernandez H. Concomitant hysteroscopic endometrial ablation and Essure procedure: feasibility, efficacy and satisfaction. Eur J Obstet Gynecol Reprod Biol 2014; 178:51-5. [PMID: 24813100 DOI: 10.1016/j.ejogrb.2014.03.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 03/18/2014] [Accepted: 03/22/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Hysteroscopic endometrial destruction procedures for abnormal uterine bleeding are an alternative to hysterectomy. Such procedures are not contraceptive and are performed on fertile patients, requiring long-term contraception. This is the first study evaluating long-term results of a combined procedure associating endometrial destruction and concomitant hysteroscopic tubal sterilization by Essure(®) micro-inserts. Our goal is to evaluate efficacy of endometrial destruction as well as hysteroscopic sterilization and satisfaction after a combined procedure in the case of abnormal uterine bleeding in non-menopausal patients. STUDY DESIGN This is a retrospective study (Canadian task force II-2) that includes 131 patients operated with combined endometrial destruction and hysteroscopic tubal sterilization between 2002 and 2011 at our university hospital. The patients were contacted to answer a questionnaire. Statistical analysis was performed with SAS© version 9.2. (SAS Institute Inc., Cary, NC). RESULTS Ninety-three patients out of 131 could be reached. The mean follow-up was of 37.8 months (min=8, max=87, SD=6.2). Thirty-eight patients (29%) were lost to follow-up. Essure(®) micro-inserts introduction success rate (evaluated on 131 patients) was 95.8%, and their position was appropriate in 81.1% of the 106 patients with position control. Efficacy of the procedure on the haemorrhagic symptoms (evaluated on 93 patients) was 80.6%. Twelve patients (12.9%) underwent a hysterectomy, 7 of which (58.3%) were a direct consequence of treatment failure. No pregnancies were reported. Satisfaction rate was of 90.3%. CONCLUSION Inadequate position rates of the micro-inserts after 3 months seem somewhat above literature findings, though no pregnancy has been reported. However, recurrent bleeding symptoms and hysterectomy rates are consistent with those observed after an endometrial destruction procedure alone. Limitations are the limited number of patients, the bias inherent to retrospective studies (lost of follow-up, selection bias). The concomitant endometrial destruction and tubal sterilization by micro-inserts is a safe and efficient procedure.
Collapse
Affiliation(s)
- Y Levy-Zauberman
- AP-HP, Hospital Bicêtre, Department of Gynaecology and Obstetric, 78 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France.
| | - G Legendre
- AP-HP, Hospital Bicêtre, Department of Gynaecology and Obstetric, 78 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France
| | - A Nazac
- AP-HP, Hospital Bicêtre, Department of Gynaecology and Obstetric, 78 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France
| | - E Faivre
- AP-HP, Hospital Antoine Béclère, Department of Gynaecology and Obstetric, 157 rue de la Porte de Trivaux, 92140 Clamart, France
| | - X Deffieux
- AP-HP, Hospital Antoine Béclère, Department of Gynaecology and Obstetric, 157 rue de la Porte de Trivaux, 92140 Clamart, France; Université Paris-Sud, 63 rue Gabriel Péri, 94270 Le Kremlin Bicêtre, France
| | - H Fernandez
- AP-HP, Hospital Bicêtre, Department of Gynaecology and Obstetric, 78 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France; INSERM U1018, CESP «Reproduction et développement de l'enfant», 82 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France; Université Paris-Sud, 63 rue Gabriel Péri, 94270 Le Kremlin Bicêtre, France
| |
Collapse
|
10
|
Regret après stérilisation tubaire hystéroscopique par technique Essure®. ACTA ACUST UNITED AC 2014; 43:387-92. [DOI: 10.1016/j.jgyn.2013.10.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2013] [Revised: 10/02/2013] [Accepted: 10/15/2013] [Indexed: 11/21/2022]
|
11
|
Essure® permanent birth control effectiveness: a seven-year survey. Eur J Obstet Gynecol Reprod Biol 2013; 168:134-7. [DOI: 10.1016/j.ejogrb.2012.12.042] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Revised: 11/24/2012] [Accepted: 12/27/2012] [Indexed: 11/21/2022]
|
12
|
Pregnancies after hysteroscopic sterilization: a systematic review. Contraception 2013; 87:539-48. [DOI: 10.1016/j.contraception.2012.08.006] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Revised: 07/26/2012] [Accepted: 08/07/2012] [Indexed: 11/17/2022]
|
13
|
Contraception permanente par pose hystéroscopique d’implants tubaires. ACTA ACUST UNITED AC 2012; 40:434-44. [DOI: 10.1016/j.gyobfe.2012.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Accepted: 04/10/2012] [Indexed: 11/20/2022]
|
14
|
[Robot-assisted coelioscopic proximal tubal reanastomosis]. ACTA ACUST UNITED AC 2012; 41:54-7. [PMID: 22521989 DOI: 10.1016/j.gyobfe.2012.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Accepted: 10/26/2011] [Indexed: 11/21/2022]
Abstract
We report two cases of robot-assisted coelioscopic proximal tubal reanastomosis after proximal tubal ligature. Patients were aged 43 and 34 years respectively and had previously undergone proximal tubal ligation by coagulation section at 37 years of age for the first patient, and by Filshie clip at 24 years for the second one. Both had regular menstrual cycles and their ovarian reserve was good. Their partners were presenting with normal sperm criteria. Proximal tubal reanastomosis was carried out in September 2010 by robotic coelioscopy with five extramucous vicryl 5-0 stitches on each tube and positive blue testing. Total durations of the interventions were 200 and 220minutes respectively. Postoperative outcomes were simple and patients had spontaneous pregnancy at 4 and 2.5 months respectively. Both pregnancies show normal progress currently. This is a contribution to literature data meant to determine the role of robotics in proximal tubal reanastomosis.
Collapse
|
15
|
Panel P, Bajka M, Le Tohic A, Ghoneimi AE, Chis C, Cotin S. Hysteroscopic placement of tubal sterilization implants: virtual reality simulator training. Surg Endosc 2012; 26:1986-96. [PMID: 22234594 DOI: 10.1007/s00464-011-2139-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Accepted: 12/15/2011] [Indexed: 11/27/2022]
Abstract
STUDY OBJECTIVE To assess face and construct validity of a new virtual reality (VR) training simulator for hysteroscopic placement of tubal sterilization implants. DESIGN Nonrandomized, controlled trial comparing responses and performance of novices and experts on the simulator. DESIGN CLASSIFICATION Canadian task force II-1. SETTING Forty-six gynecologists were personally invited or recruited at the 33rd Conference of the French National College of Gynecologists and Obstetricians (CNGOF) from December 9 to 12, 2009, grouped as 20 experts and 26 novices. They all performed the defined sequence of virtual procedures on the simulator (case 1 for familiarization, case 4 for study assessment) and finally completed the study questionnaire. MEASUREMENTS AND MAIN RESULTS Responses to realism, educational potential, and general opinion were excellent, proving face validity. Significant differences between novices and experts were assessed for 7 of the 15 metrics analyzed, proving construct validity. CONCLUSIONS We established face and construct validity for EssureSim, an educational VR simulator for hysteroscopic tubal sterilization implant placement. The next steps are to investigate convergent and predictive validity to affirm the real capacity of transferring the skills learned on the training simulator to the patient in the operating room.
Collapse
Affiliation(s)
- Pierre Panel
- Service de Gynécologie-Obstétrique, Centre Hospitalier de Versailles, Hôpital André Mignot, 177 avenue de Versailles, 78157 Le Chesnay, France.
| | | | | | | | | | | |
Collapse
|
16
|
Bipolar hysteroscopic procedures and placement of Essure microinserts for tubal sterilization: a case control study. Fertil Steril 2011; 95:2422-5. [DOI: 10.1016/j.fertnstert.2011.03.049] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2010] [Revised: 03/13/2011] [Accepted: 03/17/2011] [Indexed: 11/20/2022]
|
17
|
[Ambulatory Essure implant placement sterilization procedure for women: prospective study comparing general anesthesia versus hypnosis combined with sedation]. ACTA ACUST UNITED AC 2010; 29:889-96. [PMID: 21112724 DOI: 10.1016/j.annfar.2010.10.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2009] [Accepted: 10/15/2010] [Indexed: 11/23/2022]
Abstract
OBJECTIVE implant placement Essure, sterilization procedure for women, were performed under hypnosedation (HYP) and compared to the operative anxiety and analgesia of 12 patients operated-on under general anesthesia (GA). STUDY DESIGN prospective and comparative group study. PATIENTS AND METHODS two groups of twelve patients were matched and compared based on the choice of anesthetic technique: hypnotics (HYP) with possible additional sedation by propofol and remifentanil or GA involving propofol, sevoflurane and remifentanil. The assessment of anxiety and pain based on a visual analogy scale (0-10) and use of analgesics were studied in the recovery room and at discharge of hospital. The statistical analysis relies on nonparametric tests for paired data (Wilcoxon test). RESULTS all patients were operated. The two groups are statistically comparable. The preoperative anxiety before premedication is lower in the HYP group (p<0.05). No conversion to general anaesthesia is necessary in the HYP group, but five patients were using sedatives drugs but doses are very low compared to general anaesthesia. The analgesic consumption was equivalent in both groups. CONCLUSION we conclude that hypnosedation is a valuable alternative to traditional anesthetic techniques for ambulatory Essure implant. The use of hypnotic tool is an interesting alternative for the management of patients during invasive medical procedures or surgical, providing psychological benefits to the patient.
Collapse
|
18
|
Agostini A. [A response by A. Agostini to the article of R. Lousquy et al.: State of the art about teaching hysteroscopy to gynaecologist surgeons in France and in Europe. CONFORM investigation into training surgeons on the hysteroscopic placement of microinserts]. GYNECOLOGIE, OBSTETRIQUE & FERTILITE 2010; 38:74-75. [PMID: 20022276 DOI: 10.1016/j.gyobfe.2009.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
|
19
|
Ploteau S, Haudebourg M, Philippe HJ, Lopes P. Stérilisation tubaire par voie hystéroscopique chez les femmes de plus de quarante ans : quelle motivation pour ces femmes ? ACTA ACUST UNITED AC 2009; 37:775-9. [DOI: 10.1016/j.gyobfe.2009.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2009] [Accepted: 08/12/2009] [Indexed: 12/01/2022]
|
20
|
Lousquy R, Friederich L, Le Tohic A, Grosdemouge I, Renouvel F, Gairin F, Panel P. État des lieux de la formation des chirurgiens gynécologues à l’hystéroscopie en France et en Europe. Enquête CONFORM sur la formation à la mise en place des implants de stérilisation tubaire par voie transcervicale. ACTA ACUST UNITED AC 2009; 37:691-6. [DOI: 10.1016/j.gyobfe.2009.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2009] [Accepted: 07/03/2009] [Indexed: 10/20/2022]
|