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. 2018 Oct 30:5:8.
doi: 10.1186/s40661-018-0065-1. eCollection 2018.

Safety and feasibility of contained uterine morcellation in women undergoing laparoscopic hysterectomy

Sarah Dotson  1 , Alejandro Landa  2 , Jessie Ehrisman  3 , Angeles Alvarez Secord  3
Affiliations

Safety and feasibility of contained uterine morcellation in women undergoing laparoscopic hysterectomy

Sarah Dotson et al. Gynecol Oncol Res Pract. .

Abstract

Background: Widespread concerns have been raised regarding the safety of power morcellation of uterine specimens because of the potential to disseminate occult malignancy. We sought to assess the safety and feasibility of contained manual uterine morcellation within a plastic specimen bag among women with uterine neoplasms.

Methods: A retrospective single-institution descriptive cohort study was conducted from 2003 to 2014. Patients with leiomyoma and/or uterine malignancy who underwent minimally invasive surgery with contained uterine manual morcellation were identified from surgical logs. Demographic data, pathology results, operative details and adjuvant treatments were abstracted.

Results: Eighty-eight patients were identified; 35 with leiomyoma and 53 with endometrial cancer. The mean age was 48 and 60, respectively. Uterine size/weight was greater in women with leiomyoma compared to those with cancer (15.1 weeks/448 g vs. 10.7 weeks/322 g). Mean operative time was 206 min (range 115-391) for leiomyoma cases and 238 min (range 131-399) for cancer cases. Median length of stay was 1 day (range 0-3 days). There were no cases of occult leiomyosarcoma and all specimens were successfully manually morcellated within a bag. There were no intraoperative complications. Thirty-day postoperative complications occurred in 7 patients, including one readmission for grade (G) 1 vaginal cuff separation after intercourse, G1 port-site hematoma (1), G2 port-site cellulitis (1), G2 vaginal cuff cellulitis (2), G2 bladder infection (2), G2 pulmonary edema (1), and G1 musculoskeletal injury (1).

Conclusions: Contained uterine hand morcellation is a feasible procedure with low peri-operative complication rates that allows for minimally invasive surgical procedures for women with large uterine neoplasms. Further evaluation is needed to assess survival outcomes for uterine malignancies.

Keywords: Leiomyoma; Malignancy; Morcellation; Total laparoscopic hysterectomy.

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Conflict of interest statement

This study was approved by the Duke University Institutional Review Board. Consent to participate was waived given that retrospective chart review was used to obtain data.Not applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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