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. 2016 Oct;66(Suppl 1):567-72.
doi: 10.1007/s13224-016-0900-4. Epub 2016 May 3.

To Assess the Safety of Morcellation for Removing Uterine Specimen During Laparoscopic and Vaginal Hysterectomies for Leiomyomas

Priti Agrawal  1 , Rishi Agrawal  2 , Joytirmay Chandrakar  3
Affiliations

To Assess the Safety of Morcellation for Removing Uterine Specimen During Laparoscopic and Vaginal Hysterectomies for Leiomyomas

Priti Agrawal et al. J Obstet Gynaecol India. 2016 Oct.

Abstract

Introduction: The ability to offer less invasive surgery for leiomyomas to women often requires the removal of large tissue specimens through small incisions, which is facilitated by morcellation. Electromechanical morcellation may lead to dissemination of occult uterine malignancy throughout the intraperitoneal cavity and may worsen the prognosis.

Objectives: To assess the safety of morcellation for removing uterine specimen during laparoscopic and vaginal hysterectomies for leiomyoma and to find incidence of leiomyosarcoma (LMS) in morcellated specimens.

Materials and methods: This study was a retrospective case series done at Aarogya Hospital and Test Tube Baby Centre, Raipur, from January 1, 2011 to November 30, 2015. Total 232 cases were analyzed to assess the safety of vaginal and laparoscopic morcellation technique. All histopathological reports were analyzed to find incidence of LMS in morcellated specimen.

Results: In the study period 55.55 % hysterectomies were performed for fibroid uterus. All patients were multiparous and 82.75 % had not attained menopause. Preoperative cervical cytology and endometrial biopsy reports were not suggestive of malignancy in any case. Histopathology reports of all the morcellated specimens were consistent with leiomyoma.

Conclusion: The risk of occult LMS is extremely low, especially in reproductive age group women. We believe that more studies and guidelines are required for Indian women.

Keywords: Fibroid uterus; Laparoscopic hysterectomy; Leiomyoma; Morcellation; Uterine sarcoma; Vaginal hysterectomy.

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Conflict of interest statement

The authors declare that they have no conflict of interest. Ethical Statement All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the 1975 Declaration of Helsinki, as revised in 2008(5). Informed consent was obtained from all patients for being included in the study.

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