Nonmalignant Sequelae of Unconfined Morcellation at Laparoscopic Hysterectomy or Myomectomy

Tulandi, Togas; Leung, Annie; Jan, Noran

doi:10.1016/j.jmig.2016.01.017

Cited by 55 publications

(42 citation statements)

References 64 publications

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“…Electromechanical power morcellator is used to divide large leiomyomas into small fragments and remove them from the peritoneal cavity. During this process some of the resultant small fragments may unintentionally remain in the peritoneal cavity and become implanted, leading to subsequent growth 4 . These parasitic leiomyomas become a rare late sequela of laparoscopic myomectomy and has an incidence of 0.12-0.95%.…”

Section: Discussionmentioning

confidence: 99%

Emerging complication of laparoscopic power morcellation: a rare case of parasitic leiomyoma

Weerakoon

Mahesan

Chandrasinghe

et al. 2019

Sri Lanka J Obstet & Gynae

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Section: Discussionmentioning

confidence: 99%

Emerging complication of laparoscopic power morcellation: a rare case of parasitic leiomyoma

Weerakoon

Mahesan

Chandrasinghe

et al. 2019

Sri Lanka J Obstet & Gynae

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“…11 The etiology is unclear, but theories include the hormonal response of subperitoneal mesenchymal stem cells to undergo metaplasia and the proliferation of benign smooth muscle cells related to genetic alterations. 12 A potential iatrogenic origin is also cited, with many cases occurring after laparoscopic morcellation, especially myomectomy. Benign metastasizing leiomyoma and intravenous leiomyoma are even rarer and have no known association with laparoscopic surgery.…”

Section: Discussionmentioning

confidence: 99%

“…5,12 This rate is much higher than the prevalence of uterine sarcoma, the focus of the U.S. Food and Drug Administration's statement discouraging the use of laparoscopic power morcellators in 2014. 13 New techniques have emerged to improve the safety of tissue extraction including manual or power morcellation within a containment bag.…”

Section: Published Case Reports Of Parasitic Leiomyomas Occurring Folmentioning

confidence: 99%

Parasitic Leiomyomas Following Laparoscopic Myomectomy

Clark

Leon

Feltmate

et al. 2017

CRSLS

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“…Iatrogenic endometriosis (IE) is the presence of endometrial glands and stroma out of the uterus following certain surgical interventions, such as total or supracervical hysterectomy, myomectomy, and cesarean section [1]. The most common localizations for IE are cesarean scares (skin scare, uterus scare), trocar sites, sigmoid colon, ovaries, bladder, vaginal vault, and the parietal peritoneum [2,3]. Pain, dyspareunia, bleeding, and palpable mass are the common symptoms of IE.…”

Section: Introductionmentioning

confidence: 99%

Iatrogenic endometriosis following apical pelvic organ prolapse surgery: a case report

2020

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Background: Iatrogenic endometriosis is the presence of endometrial glands and stroma out of the uterus following certain surgical interventions. The rate of iatrogenic endometriosis after gynecologic surgeries due to benign uterine disease is 1-2%. Laparoscopic supracervical hysterectomy is also a part of frequently used surgical treatment of apical pelvic organ prolapse, which is followed by sacrocervicopexy. However, there are no data about iatrogenic endometriosis after apical prolapse surgery in the current literature. Herein, we present a case report of a patient diagnosed with de novo endometriosis 1 year after laparoscopic supracervical hysterectomy and sacrocervicopexy. Case presentation: A 46-year-old parous Slavic woman who underwent laparoscopic supracervical hysterectomy and sacrocervicopexy secondary to grade 3 symptomatic apical prolapse 1 year earlier was admitted to the same clinic with pelvic pain that had started 6 months following surgery. Deep vaginal palpation was painful. Transvaginal ultrasonography revealed an area with hypervascularization on the sacral promontory. She was scheduled for diagnostic laparoscopy. A 2 × 2-cm solid, wine-colored, hypervascular hemorrhagic lesion was seen on the sacral promontory. The lesion and the peritoneal layer behind it were totally excised. The patient was discharged on the first postoperative day, without any complications. Pathologic examination revealed foci of endometriosis comprising endometrial glands and stroma within the connective tissue, along with hemosiderin-laden macrophages. The symptoms of the patient resolved after the surgery, and no further adjuvant treatment was needed. Conclusion: Although the rate of iatrogenic endometriosis is low after laparoscopic supracervical hysterectomy and sacrocervicopexy, the possibility of the occurrence of iatrogenic endometriosis should be discussed with patients who are diagnosed with apical prolapse to determine the type of surgical intervention. Iatrogenic endometriosis should be kept in mind for differential diagnosis in case of pain after laparoscopic supracervical hysterectomy and sacrocervicopexy.

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Nonmalignant Sequelae of Unconfined Morcellation at Laparoscopic Hysterectomy or Myomectomy

Cited by 55 publications

References 64 publications

Emerging complication of laparoscopic power morcellation: a rare case of parasitic leiomyoma

Emerging complication of laparoscopic power morcellation: a rare case of parasitic leiomyoma

Parasitic Leiomyomas Following Laparoscopic Myomectomy

Iatrogenic endometriosis following apical pelvic organ prolapse surgery: a case report

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