Options on fibroid morcellation: a literature review

摘要: In laparoscopy, specimens have to be removed from the abdominal cavity. If trocar opening or vaginal outlet is insufficient pass specimen, specimen needs reduced. The power morcellator an instrument with a fast rotating cylindrical knife which aims divide tissue into smaller pieces fragments. Food and Drug Administration (FDA) issued press release in April 2014 that discouraged use of these morcellators. This article has objective review literature related complications by morcellation uterine fibroids laparoscopy offer recommendations laparoscopic surgeons gynaecology. project was initiated executive board European Society Gynaecological Endoscopy. A steering committee on fibroid installed experienced ESGE members requested chair action group address distinct clinical questions. Clinical questions were formulated regards sarcoma risk presumed fibroids, diagnosis sarcoma, future research. different subjects conducted, systematic if appropriate feasible. It concluded true prevalence not known given wide range prevalences (0.45–0.014 %) meta-analyses mainly based retrospective trials. Age certain imaging characteristics such as ‘lacunes’ suggesting necrosis increased central vascularisation tumour are associated higher although risks remain low. There enough evidence estimate this individual patients. Complications rare. Reported direct injuries vessels bowel, development so-called parasitic requiring reintervention spread cells cavity, may possibly even likely upstaging disease. Momentarily in-bag investigated it prevent complications. Because lack evidence, cannot give strong but offers only options condensed flow chart. Prospective data collection clarify issue technology extract laparoscopically cavity should perfected.