I work for a clinic which has a number of Alma machines. The Alma recommendations say not to use the Accent on any part of the body which may contain metal (within 24 inches). When I asked their clinical nurse if there were any studies done to test the effects of treating an area with metal she asked the experts in Israel and they said there were no studies. No one knows what unipolar RF will do only that monopolar RF can cause tissue "electrocution". She also didn't think this recommendation had much effect on the market. There are over 750,000 tubal each year and most use either a Filsche clip, Hulka clip, Essure coil and many women use the Paragard IUD. Some have Harrington rods, surgical clips from bowel resections or cholecystectomies. I'm familiar with bipolar and Monopolar RF, but not so with the unipolar RF. Does anyone have any experience with treating areas of the body with the Accent which has metal?