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Kim, Huh, Chang, Hong, Choi, Baek, and Seo: Removal of non-palpable Implanon™ by ultrasound guidance
Original Article
Korean Journal of Obstetrics and Gynecology

Korean Journal of Obstetrics and Gynecology 2010; 53(6): 506-511.

Published online: 30 June 2010

DOI: https://doi.org/10.5468/kjog.2010.53.6.506

Removal of non-palpable Implanon™ by ultrasound guidance

Sun Young Kim, M.D., Ji Su Huh, M.D., Min Young Chang, M.D., Yeon Hong, M.D., Bo Ram Choi, M.D., Jeong Hye Baek, M.D., Kyung Seo, M.D.

Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea.

Corresponding author (kyungseo@yuhs.ac)

Received 1 February 2010       Accepted 7 May 2010

Copyright © 2010 Korean Society of Obstetrics and Gynecology

Abstract

Objective

This study was designed to analyze outcome of removal of non-palpable Implanon™ by ultrasound guidance.

Methods

This is retrospective study of patients who were referred from local clinic where removal of non-palpable Implanon™ had been failed. The cases were 32 patients who visited to Yonsei University Gangnam Severance Hospital between March 2004 through March 2009.

Results

Implanons™ were localized on ultrasound in all 32 cases. 18 cases were located in subcutaneous layer, 10 cased were located in fascial layer, 4 cases were located in muscle layer. All cases were successfully removed. The average length of time required for removal was 19.3 minutes. There was no complication except one patient, who had mild median nerve injury.

Conclusion

Ultrasound guidance removal was safe and effective procedure to remove non palpable Implanon™.

Keywords: Removal of non-palpable Implanon™, Ultrasound guidance

Figures and Tables

Figure 1
Locating an Implanon™ with lineal probe of ultrasound sonography and 22 G needle.
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Figure 2
Injection of local anesthetic at site and insertion of 22 G long needle.
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Figure 3
Skin incision and entry of forceps toward Implanon™.
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Figure 4
Forceps removal of Implanon™ from the arm.
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Figure 5
Implanon™ was seen just proximal to the incision site at deep subcutaneous layer. Implanon™ shows echogenic nature at deep subcutaneous layer near the axilla portion.
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Figure 6
Implanon™ is located at muscular fascia.
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Figure 7
Unusual thin small diameter tubular structures are noted at just superior aspect of muscular fascia area.
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Figure 8
Longitudinal view of Implanon™ in biceps muscle.
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Table 1
Reason for removal of Implanon
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Table 2
Localization of Implanon™ on ultrasound sonography
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