Even though minimally invasive surgery has improved outcomes for hysterectomy, the procedure requires removal of the uterus through small incisions. Morcellation, or fragmentation of the uterus into smaller pieces, is one method to remove the uterus. Recently, concern has been raised that morcellation may result in the spread of undetected malignancies.
Despite the commercial availability of electric power morcellators for 2 decades, accurate estimates of the prevalence of malignancy at the time of electric power morcellation (herein referred to as morcellation) are lacking.
Among women undergoing a minimally invasive hysterectomy using electric power morcellation, uterine cancers were present in 27 per 10,000 women at the time of the procedure, according to a new study. There has been concern that this procedure, in which the uterus is fragmented into smaller pieces, may result in the spread of undetected malignancies.
Sources and More Information:
- Uterine Pathology in Women Undergoing Minimally Invasive Hysterectomy Using Morcellation, JAMA, articleid=1890400, doi:10.1001/jama.2014.9005, July 22, 2014.
- Presence of uterine cancers at time of hysterectomy studied using morcellation, ScienceDaily, 140722164353, July 22, 2014.
- Patient safety must be a priority in all aspects of care, The Lancet Oncology, Volume 15, Issue 2, Page 123, doi:10.1016/S1470-2045(14)70042-7, February 2014.
- Evaluating the Risks of Electric Uterine Morcellation, JAMA. 2014;311(9):905-906. articleid=1828692, doi:10.1001/jama.2014.1093, March 5, 2014.
- Peritoneal Dissemination Complicating Morcellation of Uterine Mesenchymal Neoplasms, PLOS one, DOI: 10.1371/journal.pone.0050058, November 26, 2012.
- Risk of occult malignancy in morcellated hysterectomy: a case series, NCBI, PMID: 21804400, 30(5):476-83. doi: 10.1097/PGP.0b013e3182107ecf, 2011 Sep.
- Robotically Assisted vs Laparoscopic Hysterectomy Among Women With Benign Gynecologic Disease, JAMA, articleid=1653522, 2013;309(7):689-698. doi:10.1001/jama.2013.186, February 20, 2013.
- The value of re-exploration in patients with inadvertently morcellated uterine sarcoma, GynecologicOncology, Volume 132, Issue 2 , Pages 360-365, article/S0090-8258(13)01351-6, February 2014