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Laparoscopic removal of an intra-abdominal intrauterine device: case and systematic review.
Contraception 2012; 85(1):15-8C

Abstract

BACKGROUND

Uterine perforation by intrauterine devices (IUDs) is a rare but well recognized complication. In the past, the presence of adhesions and perforation of viscera often resulted in the need for a laparotomy to remove the IUD. However, advances in laparoscopic technique have allowed surgeons to safely retrieve perforated IUDs. In this review, we analyze uterine perforation by an IUD and assess laparoscopic vs. open methods for removal of a perforated IUD.

STUDY DESIGN

A systematic search strategy was applied to several electronic bibliographic databases: Medline/Pubmed, Embase, Cochrane Library, and OCLC PapersFirst. Key words used were IUD, laparoscopy, and uterine perforation.

RESULTS

One hundred seventy-nine cases of attempted laparoscopic removal of perforated IUDs were identified in the English literature between 1970 and 2009. Patient age ranged from 17 to 49 years. Diagnostic laparoscopy was performed in all 179 cases reported. Laparoscopic removal of perforated IUDs was achieved successfully in 64.2% (115/179) of cases.

CONCLUSION

This systematic review highlights how advances in laparoscopic technique and skill have allowed surgeons to safely retrieve IUDs without laparotomy. We recommend an attempt at laparoscopic removal as first-line treatment in symptomatic patients and as a reasonable treatment option in asymptomatic patients.

Authors+Show Affiliations

Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Review
Systematic Review

Language

eng

PubMed ID

22067801

Citation

Gill, Richdeep S., et al. "Laparoscopic Removal of an Intra-abdominal Intrauterine Device: Case and Systematic Review." Contraception, vol. 85, no. 1, 2012, pp. 15-8.
Gill RS, Mok D, Hudson M, et al. Laparoscopic removal of an intra-abdominal intrauterine device: case and systematic review. Contraception. 2012;85(1):15-8.
Gill, R. S., Mok, D., Hudson, M., Shi, X., Birch, D. W., & Karmali, S. (2012). Laparoscopic removal of an intra-abdominal intrauterine device: case and systematic review. Contraception, 85(1), pp. 15-8. doi:10.1016/j.contraception.2011.04.015.
Gill RS, et al. Laparoscopic Removal of an Intra-abdominal Intrauterine Device: Case and Systematic Review. Contraception. 2012;85(1):15-8. PubMed PMID: 22067801.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laparoscopic removal of an intra-abdominal intrauterine device: case and systematic review. AU - Gill,Richdeep S, AU - Mok,Dereck, AU - Hudson,Matthew, AU - Shi,Xinzhe, AU - Birch,Daniel W, AU - Karmali,Shahzeer, Y1 - 2011/06/11/ PY - 2011/02/11/received PY - 2011/04/03/revised PY - 2011/04/25/accepted PY - 2011/11/10/entrez PY - 2011/11/10/pubmed PY - 2012/4/7/medline SP - 15 EP - 8 JF - Contraception JO - Contraception VL - 85 IS - 1 N2 - BACKGROUND: Uterine perforation by intrauterine devices (IUDs) is a rare but well recognized complication. In the past, the presence of adhesions and perforation of viscera often resulted in the need for a laparotomy to remove the IUD. However, advances in laparoscopic technique have allowed surgeons to safely retrieve perforated IUDs. In this review, we analyze uterine perforation by an IUD and assess laparoscopic vs. open methods for removal of a perforated IUD. STUDY DESIGN: A systematic search strategy was applied to several electronic bibliographic databases: Medline/Pubmed, Embase, Cochrane Library, and OCLC PapersFirst. Key words used were IUD, laparoscopy, and uterine perforation. RESULTS: One hundred seventy-nine cases of attempted laparoscopic removal of perforated IUDs were identified in the English literature between 1970 and 2009. Patient age ranged from 17 to 49 years. Diagnostic laparoscopy was performed in all 179 cases reported. Laparoscopic removal of perforated IUDs was achieved successfully in 64.2% (115/179) of cases. CONCLUSION: This systematic review highlights how advances in laparoscopic technique and skill have allowed surgeons to safely retrieve IUDs without laparotomy. We recommend an attempt at laparoscopic removal as first-line treatment in symptomatic patients and as a reasonable treatment option in asymptomatic patients. SN - 1879-0518 UR - https://www.unboundmedicine.com/medline/citation/22067801/Laparoscopic_removal_of_an_intra_abdominal_intrauterine_device:_case_and_systematic_review_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0010-7824(11)00180-6 DB - PRIME DP - Unbound Medicine ER -