Evaluating the Risks of Electric Uterine Morcellation
Gynecologic surgeons, like many other surgical specialists, have embraced laparoscopic surgical techniques because they offer quicker recovery, less postoperative pain, and fewer wound complications than open procedures. The removal of large pieces of tissue through the small incisions of laparoscopy is difficult. However, this problem can be overcome by tissue morcellation, a technique of fragmenting tissue into smaller pieces that often prevents the need to enlarge established incisions. Surgeons have long used manual morcellation with a scalpel or scissors to remove masses abdominally and vaginally, but use of the technique has increased with wide adoption of laparoscopic approaches and with the introduction of laparoscopic electric morcellators in 1993.
Critics of Fibroid Removal Procedure Question Risks It May Pose for Women With Undetected Uterine Cancer
Use of a surgical technique that involves cutting fibroid or uterine tissue into small pieces for extraction during minimally invasive surgery has come under scrutiny recently—scrutiny prompted by concerns that the process may disperse fragments of undetected malignant tumors throughout the abdominal cavity and upstage otherwise contained cancers.
Because it’s not possible to reliably detect the presence of uterine sarcomas before surgery, some experts say that use of the technique—known as intracorporeal uterine morcellation, which can be performed with an electric morcellator or by hand with a knife—may be too risky under any circumstance. Others say more research on risks associated with the procedure is needed before banning it outright. In the meantime, some professional groups and medical institutions are stressing the importance of counseling patients about both the potential risks and benefits of morcellation of a fibroid or uterus.
Sources and Full Text
- Evaluating the Risks of Electric Uterine Morcellation, The Journal of the American Medical Association, 1828692, 2014;311(9):905-906. doi:10.1001/jama.2014.1093.
- Critics of Fibroid Removal Procedure Question Risks It May Pose for Women With Undetected Uterine Cancer, JAMA Network, 1828691, 2014;311(9):891-893. doi:10.1001/jama.2014.27.