TY - JOUR
T1 - Medical device safety and surgical dissemination of unrecognized uterine malignancy
T2 - Morcellation in minimally invasive gynecologic surgery
AU - Hall, Tracilyn
AU - Lee, Susanna I.
AU - Boruta, David M.
AU - Goodman, Annekathryn
N1 - Publisher Copyright:
© AlphaMed Press 2015.
PY - 2015/9/17
Y1 - 2015/9/17
N2 - There is a risk of dissemination of uterine malignancies during minimally invasive hysterectomies when morcellation is used. Although the technique of uterine power morcellation allows timely removal of large benign tumors through small laparoscopic incisions, there are concerns about iatrogenic spread of cancers and reduced survival for women with preoperatively unrecognized malignancies. This review examines the literature on intraperitoneal spread and implantation of mechanically disrupted malignant tissue, discusses the current diagnostic tools for preoperative assessment of uterine tumors, and summarizes the current recommendations of the Society of Gynecologic Oncologists, the American College of Obstetricians and Gynecologists, and the American Association of Gynecologic Laparoscopists. Recommendations include informed consent of the risk of disseminating an otherwise contained malignancy, appropriate preoperative evaluation for malignancy, and development of alternatives to intracorporeal morcellation.
AB - There is a risk of dissemination of uterine malignancies during minimally invasive hysterectomies when morcellation is used. Although the technique of uterine power morcellation allows timely removal of large benign tumors through small laparoscopic incisions, there are concerns about iatrogenic spread of cancers and reduced survival for women with preoperatively unrecognized malignancies. This review examines the literature on intraperitoneal spread and implantation of mechanically disrupted malignant tissue, discusses the current diagnostic tools for preoperative assessment of uterine tumors, and summarizes the current recommendations of the Society of Gynecologic Oncologists, the American College of Obstetricians and Gynecologists, and the American Association of Gynecologic Laparoscopists. Recommendations include informed consent of the risk of disseminating an otherwise contained malignancy, appropriate preoperative evaluation for malignancy, and development of alternatives to intracorporeal morcellation.
KW - Morcellation
KW - Peritoneal dissemination
KW - Power morcellation
KW - Uterine sarcoma
UR - http://www.scopus.com/inward/record.url?scp=84946560341&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84946560341&partnerID=8YFLogxK
U2 - 10.1634/theoncologist.2015-0061
DO - 10.1634/theoncologist.2015-0061
M3 - Article
C2 - 26382742
AN - SCOPUS:84946560341
SN - 1083-7159
VL - 20
SP - 1274
EP - 1282
JO - Oncologist
JF - Oncologist
IS - 11
ER -