Alternate Implanon removal technique
Removing an Implanon can be a tricky business. Especially when it can’t be felt easily, or at all. It is surprisingly common here for a woman to be referred for removal of a deep Implanon.
Recently, my colleague Dr Sarah Luthy (already famous on this blog for her Caesarean section technique) described an alternative technique for dealing with the deep or impalpable Implanon. First, localise the implant by ultrasound and mark the ends and the line it follows. Then, make a small incision transverse to the Implanon at roughly the mid point, and dissect bluntly down until it is reached. The Implanon can then be grasped in the middle and removed by folding it in half.
I tried this recently for an implant that was embedded into the biceps muscle, and found it was much easier than the traditional technique of dissecting with a longitudinal incision over the distal tip. The sonographer had also helpfully marked the course of the basilic vein with some brief instructions – “don’t cut here!”.
What tips do you have for removing a deep Implanon? Add your comments below.