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The First Nonincisional Alternative to Tubal Ligation

What exactly is this procedure?
It is a simple incisionless procedure that does not require a hospital stay, general anesthesia or an extended recovery phase. Most women (92%) have reported they were back to normal activities in one day or less after the procedure was completed. The procedure is performed in our office or as an outpatient.

Which women would be interested in this procedure?
Like tubal ligation, Essure is a permanent method of birth control. It has been a popular idea from the beginning, and is experiencing increasing demand from women who have completed their childbearing. Since it does not require general anesthesia as an office procedure, it is especially popular.

How much does it cost?
Insurance reimbursement varies from company to company, but insurance companies, because of the reduction in costs, welcome the procedure. Essure eliminates the need for payment for anesthesia or inpatient stays. Since the procedure is now offered directly in the office of Dr. Hubbell, along with the outpatient option, substantial savings result. Often deductibles do not apply to the procedure when performed in an office setting.

How long have doctors been performing this type of sterilization?
Initial studies required for FDA approval have been ongoing for five years, with the FDA granting approval in 2002. It is interesting to note no failures have occurred to date. Current results give the Essure a 99.8% effective rate. World wide, 52,000 women have already embraced this option for tubal ligation.

Where can I get this done?
Dr. Hubbell offers the Essure in two settings. Since 2003, he has been using the method at Lake Regional Hospital as an outpatient procedure. In 2005, he began performing Essure insertions in the office setting. Women's Health Consultants is the only practice to be an Essure accreditted practice and Dr. Hubbell was the first in Missouri to offer an office setting for the procedure.

How exactly does the physician perform this procedure?
The device is a coil made of medical grade materials, similar in composition to devices that have been medically placed in patients in other parts of the body for decades. The physician places the device, using a telegraphing instrument, or hysteroscope, in each fallopian tube. Dr. Hubbell is an experienced hysteroscopist, with two decades of expertise since he completed his training at the University of Michigan.

How long will I have to be at Dr. Hubbell's office for the Essure to be inserted?
The procedure takes approximately 10 minutes. Most patients leave for home within 30 minutes.

Who do I contact to discuss if the Essure it right for me?
Laura Greenleaf, office manager at Women's Health Consultants, will be able to address your questions. Her number is (573) 348-6101 Extension 18. As well, if you have an appointment with Dr. Hubbell, simply inform the receptionist that you wish to discuss the Essure procedure.

There is also an excellent website for patients:

In summary: In November of 2002, the FDA approved the Essure device, which consists of micro-inserts, placed to block the fallopian tubes. Using a hysteroscope or telescoping type of instrument, a small coiled device is inserted into the uterus where the fallopian tubes connect to the uterine cavity. Device placement does not involve incisions, cutting, crushing or burning the fallopian tubes. This method is irreversible and highly effective in preventing pregnancy. In the FDA studies to date, no failures were reported by women who rely on the Essure device exclusively for birth control. In over 250,000 cases worldwide, the failure rate is less than 0.2%.

In an outpatient or office setting, the device placement only requires local anesthetic for pain control. Placement is possible in approximently 95% of cases. Complication rates are extremely low and the procedure can be performed in women who have contraindications for traditional abdominal sterilization (tubal ligation) procedures, i.e. obesity, former pelvic or abdominal surgery or severe pelvic adhesions. Contraindications to the Essure procedure include nickel allergies, previous tubal ligation, or uncertainty regarding desire for future fertility. Those with STDs, unevaluated abnormal Pap smears, or those who think they may be pregnant or wish to become pregnant at any time should not undergo the procedure. The average time of the procedure is approximately 10 minutes with a short recovery period following. The majority of patients return to work the next day, as opposed to a delay of four to seven days with a traditional minimally  invasive abdominal approach.

A woman must use another form of birth control during the healing time of approximately 12 weeks. This is comparable to the time required for a vasectomy to be effective in a man. The Essure procedure does not protect against HIV or STDs, nor does it contain hormones. Most insurance carriers have covered procedural costs, welcoming the decreased overall cost for the procedure.

As with all methods of birth control, Essure is not considered 100% effective. A study to confirm blocked tubes is performed in approximately 12 weeks as a simple outpatient radiographic hysterosalpingogram (HSG). This confirms the occlusion of both fallopian tubes and can verify the satisfactory micro-insert location. Subsequent diagnostic procedures such a MRI and CT scans are still possible if needed.

Additionally, with all medical procedures there are associated risks. This is true of both the Essure device and the Essure placement procedure. Because there are no abdominal incisions and general anesthesia is not required, the associated risks are more typical of hysteroscopic procedures. Adverse events have all been minor in the clinical experience to date.

The Essure procedure has been available since 2003 at Lake Regional Hospital and in an office setting at Dr. Hubbell's office since 2005, answering the need for a new contraceptive alternative for women in the Lake area.

Forms For Essure Procedure
Women's Health Consultants