Power morcellators: a review of current practice and assessment of risk

Power morcellation has come under scrutiny because of a highly publicized case of disseminated leiomyosarcoma following a laparoscopic hysterectomy. A recent Federal and Drug Administration safety communication discouraging use of power morcellators on presumed uterine leiomyoma further highlights t...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2015-01, Vol.212 (1), p.18-23
Main Authors: Senapati, Sangeeta, MD, MS, Tu, Frank F., MD MPH, Magrina, Javier F., MD
Format: Article
Language:English
Subjects:
Female
Humans
hysterectomy
Hysterectomy - adverse effects
Hysterectomy - instrumentation
Hysterectomy - methods
leiomyoma
Leiomyoma - surgery
morcellation
myomectomy
Obstetrics and Gynecology
Practice Patterns, Physicians
Risk Assessment
uterine malignancy
Uterine Neoplasms - surgery
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Summary:Power morcellation has come under scrutiny because of a highly publicized case of disseminated leiomyosarcoma following a laparoscopic hysterectomy. A recent Federal and Drug Administration safety communication discouraging use of power morcellators on presumed uterine leiomyoma further highlights the need for reexamination of uterine tissue extraction. This clinical opinion aims to summarize current approaches to uterine/fibroid tissue extraction including the associated immediate and long-term potential risks of open power morcellation. The known data about risk of uterine sarcoma is reviewed followed by a discussion of acceptable risk and informed consent in the context of shared-decision making.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2014.07.046