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New insertion site for Nexplanon insertion
  1. Martyn R Walling
  1. Sidlings Medical Practice, Boston, UK
  1. Correspondence to Dr Martyn R Walling, Sidlings Medical Practice, Boston, UK; martyn.belmontdoc{at}sky.com

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In October 2018, Merck Sharp and Dohme (MSD) changed the advised area of the arm where Nexplanon should be inserted. They are doing this because of the very rare but serious complication of cardiovascular insertions. During the past 18 months, they have been discussing with anatomists and others where is the best place to insert Nexplanon that avoids this complication. After this long discussion period, they have decided on 3–5 cms away from the biceps/triceps sulcus over triceps. This decision was relayed at the Annual Expert Remover Meeting in late 2018 without involving this group of experienced impalpable implant practitioners for their thoughts. To insert in this position, they are advising the arm will need to be rotated back with the hand behind the patients head so that the arm will be on the couch. The implant insertion is far away from the …

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