***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: BACKGROUND The aim of this study was to assess the diagnostic accuracy of three-dimensional ultrasound ( 3D-US ) for determining the position of Essure microinserts and the success of sterilization by the Essure method . METHODS This retrospective observational study examined the case records of 311 women who underwent hysteroscopic sterilization from October 2002 through October 2008 .  Imaging with 3D-US or pelvic X-radiography or both was performed 3 months after the procedure to verify device position . Hysterosalpingography ( HSG ) was performed when a bilateral procedure was not completed because of a history of salpingectomy or blocked tube , when doubt persisted after 3D-US or pelvic radiography , or for comparative purpose s in a prospect i ve study . The positions seen on 3D-US were classified in four categories according to a specific scale we devised . RESULTS The insertion procedure was completed in 94.2 % patients . Only 90.5 % underwent imaging verification of the device 3 months afterwards . In all , 227 3D-US , 175 pelvic radiography and 64 HSG imaging procedures were performed . Visualization of the device was possible in 99.6 % of the 3D-US images . According to our classification , 3D-US was appropriate for assessing device position for 195 ( 85.9 % ) patients . The need for HSG confirmation was significantly lower with 3D-US than radiographic imaging ( 14.1 versus 26.8 % , P = 0.001 ) . 3D-US examinations , compared with the results of HSG as the reference test , had a sensitivity of 100 % and a specificity of 76.6 % . Neither pregnancy nor early expulsion occurred when 3D-US found that the devices were correctly placed . CONCLUSIONS 3D-US is a simple technique for assessing the position of Essure ( ® ) microinserts , even after concomitant endometrial surgery . The 3D-US classification presented here appears to make it possible to use HSG for back-up confirmation only when the microinsert is found in a very distal position on 3D-US and thus to protect the majority of women from the negative effects of pelvic radiography and HSG Objective To compare patient satisfaction , discomfort , procedure time , success rate and adverse events of  hysteroscopic  ( ESSURE , Conceptus Inc , San Carlos , USA ) versus laparoscopic sterilisation OBJECTIVE To assess the safety , effectiveness , and reliability of a tubal occlusion microinsert for permanent contraception , as well as to document patient recovery from the placement procedure and overall patient satisfaction . METHODS A cohort of 518 previously fertile women seeking sterilization participated in this prospect i ve , phase III , international , multicenter trial . Microinsert placement was attempted in 507 women .  Microinserts were placed bilaterally into the proximal fallopian tube lumens under hysteroscopic visualization in outpatient procedures . RESULTS Bilateral placement of the microinsert was achieved in 464 ( 92 % ) of 507 women . The most common reasons for failure to achieve satisfactory placement were tubal obstruction and stenosis or difficult access to the proximal tubal lumen . More than half of the women rated the average pain during the procedure as either mild or none , and 88 % rated tolerance of device placement procedure as good to excellent . Average time to discharge was 80 minutes . Sixty percent of women returned to normal function within 1 day or less , and 92 % missed 1 day or less of work . Three months after placement , correct microinsert placement and tubal occlusion were confirmed in 96 % and 92 % of cases , respectively . Comfort was rated as good to excellent by 99 % of women at all follow-up visits . Ultimately , 449 of 518 women ( 87 % ) could rely on the microinsert for permanent contraception . After 9620 woman-months of exposure to intercourse , no pregnancies have been recorded . CONCLUSION This study demonstrates that hysteroscopic interval tubal sterilization with microinserts is well tolerated and results in rapid recovery , high patient satisfaction , and effective permanent contraception STUDY OBJECTIVES To evaluate the efficacy of performing the Essure hysteroscopic sterilization  in an office-based setting . DESIGN Prospect i ve , longitudinal analysis ( Canadian Task Force classification II-3 ) . SETTING University out-patient office . PATIENTS All patients undergoing permanent sterilization in our outpatient office who opted for hysteroscopic sterilization were included . INTERVENTIONS Hysteroscopic placement of the Essure device in an office-based setting with only non-steroidal antiinflammatory drugs and paracervical block . MEASUREMENTS AND MAIN RESULTS Multiple data points were collected on each patient including demographic data , specific procedural information , and 12-week hysterosalpingogram data .  Most of our patients were Hispanic and had an average body mass index of 30.3 .  Average time to perform the procedure was 12.4 minutes , with the steepest improvement in the first 13 cases . Bilateral placement of the device was successful in 98 ( 96 % ) of 102 patients . Of these patients 92 have 12-week hysterosalpingography results ( 6 patients were lost to follow-up ) , with 90 ( 98 % ) showing bilateral tubal occlusion . There were no intraprocedural or postprocedural complications . CONCLUSION In our institution and in our experience , office-hysteroscopic placement of the Essure device is a feasible and effective approach for permanent sterilization BACKGROUND Unlike laparoscopic surgery for interval tubal sterilization , a hysteroscopic approach obviates surgical incision and requires only local anaesthesia or intravenous sedation . The safety , tolerability and efficacy of an hysteroscopically placed micro-insert device was evaluated . METHODS A cohort of 227 previously fertile women participated in this prospect i ve international multicentre trial .  Micro-inserts were placed bilaterally into the proximal Fallopian tube lumens under hysteroscopic visualization in outpatient procedures . RESULTS Successful bilateral micro-insert placement was achieved in 88 % of women . The majority of women reported that intraprocedural pain was less than or equal to that expected , and 90 % rated tolerance of the device placement procedure as good to excellent . Most women could be discharged in an ambulatory state within 1 - 2 h. Adverse events occurred in 7 % of the women , but none was serious . Correct device placement was confirmed in 97 % of cases at 3 months . Over 24 months follow-up , 98 % of study participants rated their tolerance of the micro-insert as very good to excellent . After 6015 woman-months of exposure to intercourse , no pregnancies have been recorded . CONCLUSIONS Hysteroscopic sterilization result ed in rapid patient recovery without unacceptable post-procedure pain , as well as high long-term patient tolerability , satisfaction and effective permanent contraception OBJECTIVE To evaluate women 's satisfaction and tolerance of hysteroscopic sterilization .  DESIGN Prospect i ve analysis of case series . SETTING Gynecology department in a teaching hospital . PATIENT(S ) A total of 1,630 women who underwent hysteroscopic sterilization by placement of Essure microinserts ( Conceptus , Inc. , Mountain View , CA ) from January 2003 to June 2006 . INTERVENTION(S ) Transvaginal ultrasound examination , pelvic x-ray examination , and hysterosalpingography 3 months after sterilization with Essure microinserts .  Satisfaction was assessed by a visual analog scale . Adverse effects and tolerance also were recorded . MAIN OUTCOME MEASURE(S ) Transvaginal ultrasound and pelvic x-ray confirmation of correct localization of microinserts and patient 's satisfaction and tolerance after a 3-month follow-up . RESULT ( S ) The rate of successful insertion was 99 % . Most of women returned to their daily activities on the same day of insertion , and 86.5 % considered the procedure painless or scarcely painful . All the patients were highly satisfied after hysteroscopic sterilization : 91 % of subjects by visual analog scale ( on a 0 to 10 scale ) rated the method at 10 ( high satisfaction degree ) , and none of the subjects rated it under 8 . For patients , the most valuable aspects of the procedure were absence of surgery room ( 52.7 % ) , method 's quickness and comfort ( 19.9 % ) , and permanent sterilization ( 18.2 % ) . More than 97 % of the patients said that they would recommend the procedure to others . CONCLUSION ( S ) This study provides evidence that Essure microinserts can be placed in a usual gynecologic consultation room in st and ard conditions without any type of anesthesia or sedation and are associated with great overall patient satisfaction . Women also have high tolerance for the procedure and describe minor postoperative pain STUDY OBJECTIVE To compare hysteroscopic female sterilization procedures performed in-office versus a hospital operating room ( OR ) among newly trained physicians . DESIGN Multisite hospital operating rooms and physician offices . PATIENTS Women desiring permanent hysteroscopic sterilization . INTERVENTION Hysteroscopic female sterilization with the Essure system . MEASUREMENTS AND MAIN RESULTS Procedure time ( scope in/scope out time ) , device placement rates , and incidence of complications and adverse events were compared . There was no significant difference in scope time between the 2 setting s. There was no significant difference in placement rates , although the placement rate was somewhat higher in-office ( 91 % vs 88 % ) . There were no complications among any of the procedures , and the incidence of minor adverse events was extremely low in both setting s ( OR=2 % , in-office=1 % ) . CONCLUSION There is no clear advantage to performing hysteroscopic sterilization in a hospital OR . Hysteroscopic sterilization can be performed safely and efficiently in an office setting OBJECTIVES Hysteroscopic flexible micro-insert ( Essure ) is an ambulatory improvement of fallopian tube sterilization , which is a deliberated suppression of fertility . The aim of this study was an evaluation of feasibility ( learning curve ) and the first year outcome of this method . PATIENTS AND METHODS This prospect i ve study , carried out between February 2002 and March 2003 , included patients who were matching with manufacturer recommendations . One surgeon only realized all the device placements . RESULTS Fifty patients were included ( one year follow-up ) . Mean age was 41 ( + /-3.3 ) , mean parity was 2.7 ( + /-0.8 ) .  Mean time needed for device placement was 26 minutes ( + /-6.5 ) and was reduced with increased experience . Six failures of placement ( 12 % ) were related , because of submucus leiomyomas , proximal tubal stenotic disease or too retroverted uterus . Only 5 patients ( 11,4 % ) described intensive pelvic pain during the placement . The only case of device expulsion benefited from a successful second placement . The one-year follow-up showed no significant difference of body weight increasing , duration or quantity of menstruation , neither significant pelvic pain nor vaginal bleeding . Tolerance was rated at least at " somewhat satisfied " . There have been no pregnancies reported in 670 woman-months of effectiveness . DISCUSSION AND CONCLUSION Our results agree in any point with those of larger studies . We think that hysteroscopy micro-insert placement is not only reserved to specialized centers but also to any gynecologist who is used to performing hysteroscopy because of its feasibility STUDY OBJECTIVE To assess the safety and placement effectiveness of a new delivery catheter for the Essure micro-insert hysteroscopic sterilization system . DESIGN Prospect i ve , multicenter , single-arm clinical study . ( Canadian Task Force classification II-3 ) . SETTING Hospital-based clinical research centers . PATIENTS One hundred two women of reproductive age and proven fertility . INTERVENTION A new coil catheter delivery system was used for micro-insert placement . MEASUREMENTS AND MAIN RESULTS The bilateral placement of micro-inserts using the coil catheter delivery system occurred in 100 women out of 102 attempts ( 98 % ) . The two women who did not have successful micro-insert placement were subsequently shown to have proximal tubal stenotic disease . CONCLUSION These findings indicate that the introduction of the coil catheter delivery system for Essure hysteroscopic sterilization improves the micro-insert bilateral placement rate when compared with previous studies . It is hypothesized that the coil catheter has superior navigational properties , particularly within tortuous or narrowed tubal lumens Objective To estimate the risk of intraoperative or postoperative complications for  interval laparoscopic tubal sterilizations .  Methods We used a prospect i ve , multicenter cohort study of 9475 women who had interval laparoscopic tubal sterilization  to calculate the rates of intraoperative or postoperative complications . The relative safety of various methods was assessed by calculating overall complication rates for each major method of tubal occlusion . Method -related complication rates also were calculated and included only complications attributable to a method of occlusion . We used logistic regression to identify independent predictors of one or more complications . Results When we used a more restrictive definition of unintended major surgery , the overall rate of complications went from 1.6 to 0.9 per 100 procedures . There was one life-threatening event and there were no deaths . Complications rates for each of the four major methods of tubal occlusion ranged from 1.17 to 1.95 , with no 
    Output:
    
Overall , hysteroscopic sterilization is associated with lower pregnancy rates and lower complication rates compared to tubal ligation .
No deaths have been reported for hysteroscopic sterilization .
This review indicates that hysteroscopic tubal sterilization is associated with : lower pregnancy rates compared to tubal ligation ; lower complication rates compared to tubal ligation ; no significant improvement in patient satisfaction compared to tubal ligation .