Session V B, Slide #1

Contraceptive Implants

Session V B: Two-Rod Implant Removal

Session V B, Slide #2

Two-Rod Implant Removal: Required Equipment

• An examination table• Sterile surgical drapes and

gloves• Antiseptic solution• Local anesthetic, needles,

and syringe• Sterile #11 scalpel, forceps

(straight and curved mosquito)

• Skin closure, sterile gauze and compresses

Session V B, Slide #3

Two-Rod Implant Removal

Step 1

• Have the client lie on her back with her arm flexed at the elbow.

• Palpate the area to locate both implants.

• Clean the patient’s upper arm with an antiseptic solution and frame the area with a drape that has an opening.

Session V B, Slide #4

• Apply a small amount of local anesthetic, such as lidocaine (1%) to the skin and under the ends of the implants (below the bottom of the “V”). This will raise the ends of the implants.

Two-Rod Implant Removal

Step 2

Session V B, Slide #5

• Make a 4 mm incision with the scalpel close to the ends of the implants (below the bottom of the “V”).

• Do not make a large incision.

Two-Rod Implant Removal

Step 3

Session V B, Slide #6

• Push each implant gently toward the incision with your fingers.

• When the tip is visible or near to the incision, grasp it with mosquito forceps.

Two-Rod Implant Removal

Step 4

Session V B, Slide #7

• Use the scalpel, the other forceps, or gauze to very gently open the tissue sheath that has formed around the implant.

Two-Rod Implant Removal

Step 5

Session V B, Slide #8

• Grasp the end of the implant with the second forceps and gently remove it.

• Repeat the procedure for the second implant.

Two-Rod Implant Removal

Step 6

Session V B, Slide #9

• Close the incision with a skin closure.

• Apply a sterile gauze and wrap the arm with a pressure bandage.

• Before the client is discharged, observe her for a few minutes for signs of bleeding from the insertion site.

• Review post-removal instructions and other key messages.

• Clean or dispose of the instruments properly.

Two-Rod Implant Removal

Step 7

Session V B, Slide #10

Post-removal Options

• If the woman decided to keep using this method and is still eligible, insert a new set of implants through the same incision, or if the client prefers, use the other arm.

• If the woman decided to discontinue using implants and does not want to become pregnant, counsel her about other contraceptive options.