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https://www.readbyqxmd.com/read/28218964/temporal-trends-in-minimally-invasive-myomectomy-before-and-after-the-us-food-and-drug-administration-recommendation-against-electric-morcellation
#1
Nigel Pereira, William C Frankel, Anne P Hutchinson, Hency H Patel, Cheri Mostisser, Rony T Elias
OBJECTIVE: To investigate the temporal trends in minimally invasive myomectomy at one reproductive medicine center before and after the US Food and Drug Administration (FDA) recommendation against electric morcellation. METHODS: A retrospective chart review was undertaken of patients undergoing minimally invasive myomectomy between April 1, 2012, and April 30, 2016, at a center in New York. Temporal trends in laparoscopic myomectomy (LM), robot-assisted laparoscopic myomectomy (RAM), and laparoscopically assisted myomectomy (LAM), and intraoperative and postoperative outcomes before and after the April 2014 recommendation were compared...
February 20, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28216458/incidence-of-malignancy-and-fibroid-variants-at-surgery-for-presumed-benign-symptomatic-fibroids
#2
Monique Ramos Damasco, Pui-Wan Kiri Chan, Marnie Slonim, Woun-Eng Catarina Ang, Martin Graham Healey
STUDY OBJECTIVE: In women undergoing hysterectomy or myomectomy for benign gynecology indications, where fibroids were present, to estimate the incidence of (1) leiomyosarcoma (LMS), (2) other uterine pathology (3) the frequency of use of morcellation, both mechanical and manual in laparoscopic, vaginal and laparotomy operative routes. DESIGN: Retrospective study (Canadian Task Force classification II-3). SETTING: The Royal Women's Hospital, Melbourne Australia...
February 16, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28209496/uterine-leiomyosarcoma-epidemiology-contemporary-treatment-strategies-and-the-impact-of-uterine-morcellation
#3
Stephanie Ricci, Rebecca L Stone, Amanda N Fader
Leiomyosarcoma, a rare tumor subtype, accounts for 1% of all uterine malignancies, but contributes to a significant proportion of uterine cancer deaths. Surgery is considered the mainstay of treatment for all soft tissue sarcomas, including uterine variants. However, uterine leiomyosarcoma is challenging to diagnose preoperatively and can mimic the appearance of benign uterine leiomyomas. Recently, concerns have grown in this regard, as surgeons have utilized uterine morcellation and myomectomy procedures unknowingly in the setting of occult uterine sarcoma...
February 13, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28203626/diffuse-peritoneal-leiomyomatosis-status-post-laparoscopic-hysterectomy-with-power-morcellation-a-case-report-with-review-of-literature
#4
Don Nguyen, Rishi Maheshwary, Cassie Tran, Scott Rudkin, Luke Treaster
•Leiomyomatosis following laparoscopic hysterectomy with morcellation is reported.•Parasitic myomas grow in a benign fashion but may be fatal depending on location.•Fibroids are a contraindication for laparoscopic hysterectomy with morcellation.•Containment bags may address intraperitoneal spillage of malignant tissue.
February 2017: Gynecologic Oncology Reports
https://www.readbyqxmd.com/read/28179197/laparoendoscopic-single-site-total-laparoscopic-hysterectomy-clinical-factors-that-affect-operative-times-and-techniques-to-overcome-difficulties
#5
In Cheul Jeung, Yong Seok Lee, Min Jong Song, Eun Kyung Park
STUDY OBJECTIVE: To compare surgical outcomes of patients who underwent laparoendoscopic single-site total laparoscopic hysterectomy (LESS-TLH) with operative times <150 minutes and ≥150 minutes to determine the clinical factors that influence operative times. We also describe techniques that help overcome difficulties involved in this procedure. DESIGN: Retrospective study. DESIGN: Classification: Canadian Task Force Classification II-2...
February 4, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28170091/prevalence-of-occult-pre-malignant-or-malignant-pathology-at-the-time-of-uterine-morcellation-for-benign-disease
#6
Emily C Von Bargen, Cara L Grimes, Kavita Mishra, Rui Wang, Miriam J Haviland, Michele R Hacker, Joseph A Carnevale, Alyssa J Estes, Eman A Elkadry
OBJECTIVE: To determine the prevalence of occult pre-malignant or malignant uterine pathology at the time of laparoscopic surgery with open power morcellation for benign gynecologic disease. METHOD: The present multicenter, retrospective cohort study included women who underwent open power morcellation for benign indications between January 1, 2007, and February 28, 2014, at three academic medical centers in the USA. The primary outcome was pre-malignant or malignant pathology at the time of open power morcellation, and was determined from the patients' pathology reports...
February 7, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28159054/long-term-sequelae-of-unconfined-morcellation-during-laparoscopic-gynecological-surgery
#7
REVIEW
Aviad Cohen, Togas Tulandi
Although rare, unconfined morcellation of occult sarcoma has been associated with reduced survival rates. Morcellation of uterus and myoma can also lead to iatrogenic endometriosis, parasitic myoma and, albeit rarely, disseminated peritoneal leiomyomatosis. These benign sequelae of morcellation occur more often than malignant dissemination of sarcomatous tissue. Accordingly, confined morcellation should be performed with a minimally invasive technique while eliminating tissue dissemination inside the abdominal cavity...
March 2017: Maturitas
https://www.readbyqxmd.com/read/28152961/banning-the-use-of-intracorporeal-morcellation
#8
Stephen F Rechner, Douglas M VanDrie, Ralph N Rogers
: 132 Background: In response to the FDA safety communication we banned the use of intracorporeal morcellation effective April 22(nd) 2014. Clinicians expressed frustration and a concern that an increase in the abdominal hysterectomy rate or percentage, wound complications, and length of stay would occur. Our PDCA (plan, do, check, and act) safety process reviewed these quality and safety metrics one year later. METHODS: This is a retrospective evaluation of a prospective institutional decision...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28144125/to-morcellate-or-not-to-morcellate-a-cross-sectional-survey-of-gynecologic-surgeons
#9
Farr Nezhat, Radu Apostol, Alexis D Greene, Marjorie L Pilkinton
BACKGROUND AND OBJECTIVES: The inadvertent dissemination of uterine cancer cells with the power morcellator has received much attention in the press and a warning from the U.S. Food and Drug Administration. Many hospitals prohibit the use of the morcellator in gynecologic surgery. We conducted a survey in an attempt to assess gynecologic surgeons' beliefs regarding the intracorporeal power morcellation of fibroids in light of the risk of dissemination of malignancy in patients in whom the presence of cancer is unknown before surgery...
January 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28120430/morcellating-uterine-mesenchymal-tumors-the-pathologist-s-view
#10
Kitty Pavlakis, Irini Messini, Petros Yiannou, Theofani Gavresea, Dimitris Chrysanthakis, Georgios Hilaris, Theodoros Panoskaltsis
AIM: The study was conducted to delineate the histological problems in diagnosing uterine mesenchymal tumors in morcellated material. METHODS: All cases of morcellated uteri performed between 2008 and 2014 were reviewed. The incidence of unexpected malignancy, defined as any neoplasm with a clear-cut diagnosis of leiomyosarcoma (LMS) or endometrial stromal sarcoma (ESS), was noted. Cases with absolute discrepancy between the diagnosis of the morcellated tumor and the subsequent diagnosis were also included in the study...
January 25, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28104498/laparoscopic-myomectomy-a-single-centre-retrospective-review-of-514-patients
#11
Elisabeth Mary Ruth Bean, Alfred Cutner, Tom Holland, Arvind Vashisht, Davor Jurkovic, Ertan Saridogan
STUDY OBJECTIVE: To review surgical outcomes and histopathological findings following laparoscopic myomectomy by a team at a university teaching hospital. DESIGN: This was a retrospective review of consecutive cases of laparoscopic myomectomy carried out by members of our minimal access surgery team between January 2004 and December 2015. DESIGN CLASSIFICATION: Canadian Task Force Classification II-3 SETTING: University Teaching Hospital PATIENTS: Women undergoing laparoscopic myomectomy INTERVENTIONS: Laparoscopic myomectomy MEASUREMENTS AND MAIN RESULTS: We collected women's demographic data, clinical histories and surgical outcomes, including complication rates and the incidence of undiagnosed uterine malignancy...
January 16, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28099700/a-systematic-review-and-meta-analysis-of-randomized-controlled-trials-comparing-hysteroscopic-morcellation-with-resectoscopy-for-patients-with-endometrial-lesions
#12
REVIEW
Chunbo Li, Zhiyuan Dai, Yuping Gong, Bingying Xie, Bei Wang
BACKGROUND: Results on the efficacy of hysteroscopic morcellation for patients with endometrial lesions remain conflicting. OBJECTIVES: To compare hysteroscopic morcellation with conventional resectoscopy for removal of endometrial lesions. SEARCH STRATEGY: Electronic databases were searched for reports published up to February 1, 2016, using terms such as "morcellator," "morcellators," "morcellate," "morcellation," "morcellated," "hysteroscopy," "hysteroscopy," "uteroscope," and "transcervical...
January 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28063564/mise-%C3%A3-jour-technique-sur-le-morcellement-tissulaire-dans-le-cadre-d-une-chirurgie-gyn%C3%A3-cologique-son-utilisation-ses-complications-et-les-risques-li%C3%A3-s-%C3%A3-la-pr%C3%A3-sence-insoup%C3%A3-onn%C3%A3-e-de-tumeurs-malignes
#13
Sukhbir S Singh, Stephanie Scott, Olga Bougie, Nicholas Leyland
No abstract text is available yet for this article.
December 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28012757/laparoscopic-nephrectomy-initial-case-report
#14
Ralph V Clayman, Louis R Kavoussi, Nathaniel J Soper, Stephen M Dierks, Shimon Meretyk, Michael D Darcy, Frederick D Roemer, Edward D Pingleton, Paul G Thomson, Stephenie R Long
A tumor-bearing right kidney was completely excised from an 85-year-old woman using a laparoscopic approach. A newly devised method for intra-abdominal organ entrapment and a recently developed laparoscopic tissue morcellator made it possible to deliver the 190 gm. kidney through an 11 mm. incision.
December 21, 2016: Journal of Urology
https://www.readbyqxmd.com/read/28002210/european-society-of-gynecological-oncology-statement-on-fibroid-and-uterine-morcellation
#15
Michael J Halaska, Dimitrios Haidopoulos, Frédéric Guyon, Philippe Morice, Ignacio Zapardiel, Vesna Kesic
Recently, there has been an intense discussion about the issue of fibroid and uterine morcellation in relation to the risk of unrecognized uterine sarcoma spread. Morcellation can negatively influence the prognosis of patients, and transecting the specimen into pieces prevents the pathologist from performing proper disease staging. Many societies have published their statements regarding this issue. The European Society for Gynecological Oncology has established a working group of clinicians involved in diagnostics and treatment of oncogynecological patients to provide a statement from the oncological point of view...
January 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/27981854/a-prospective-randomized-study-comparing-disposable-with-reusable-blades-for-a-morcellator-device
#16
Benedikt Becker, Ann Katrin Orywal, Teresa Hausmann, Andreas J Gross, Christopher Netsch
INTRODUCTION & OBJECTIVES: Transurethral enucleation of the prostate for the management of benign prostatic obstruction (BPO) involves two steps: the enucleation and morcellation procedure. The aim of our study was to assess the efficacy of a morcellator device using disposable and reusable blades with different settings of morcellation speed. METHODS: A prospective randomized study was initiated for patients with symptomatic BPO undergoing Thulium laser enucleation of the prostate...
January 12, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/27965523/a-prospective-multicenter-registry-of-patients-undergoing-hysteroscopic-morcellation-of-uterine-polyps-and-myomas
#17
Michael D Scheiber, Serena H Chen
Background: Hysteroscopic morcellation removes uterine pathology under direct visualization with continuous real-time tissue fragment removal. Objective: The aim of this study was to explore the feasibility of hysteroscopic morcellation across a diverse set of facilities, including both surgical and office-based settings. Design: This was a prospective, single-arm, multicenter registry development (Canadian Task Force classification II-3). Materials and Methods: Thirty-four U.S. obstetrics and gynecology facilities enrolled subjects into the registry...
December 1, 2016: Journal of Gynecologic Surgery
https://www.readbyqxmd.com/read/27890646/laparoscopic-hysterectomy-with-morcellation-vs-abdominal-hysterectomy-for-presumed-fibroids-an-updated-decision-analysis-following-the-2014-food-and-drug-administration-safety-communications
#18
Matthew T Siedhoff, Kemi M Doll, Daniel L Clarke-Pearson, Sarah E Rutstein
Previous decision analyses demonstrate the safety of minimally invasive hysterectomy for presumed benign fibroids, accounting for the risk of occult leiomyosarcoma and the differential mortality risk associated with laparotomy. Studies published since the 2014 Food and Drug Administration safety communications offer updated leiomyosarcoma incidence estimates. Incorporating these studies suggests that mortality rates are low following hysterectomy for presumed benign fibroids overall, and a minimally invasive approach remains a safe option...
November 24, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27889177/-assessment-of-the-learning-curves-for-intravesical-adenoma-morcellation-using-piranha-%C3%A2-device-during-endoscopic-enucleation
#19
V Misrai, B Bordier, J Guillotreau
INTRODUCTION: Morcellation of intravesical adenoma (MIA) is an important part of the endoscopic enucleation procedure. The aim of this study was to analyse the learning curve of the MIA during endoscopic enucleation of the prostate. MATERIAL: We conducted a prospective study of the first 90 patients treated by endoscopic enucleation of the prostate by a single surgeon without previous experience of MIA. The population was divided into 3 consecutive groups of 30 patients...
November 23, 2016: Progrès en Urologie
https://www.readbyqxmd.com/read/27817933/morcellation-worsens-survival-outcomes-in-patients-with-undiagnosed-uterine-leiomyosarcomas-a-retrospective-mito-group-study
#20
Francesco Raspagliesi, Giuseppa Maltese, Giorgio Bogani, Giovanni Fucà, Stefano Lepori, Pierandrea De Iaco, Myriam Perrone, Giovanni Scambia, Gennaro Cormio, Stefano Bogliolo, Alice Bergamini, Giuseppe Bifulco, Paolo Giovanni Casali, Domenica Lorusso
OBJECTIVE: To investigate the impact of morcellation on survival outcomes of patients affected by undiagnosed uterine sarcoma. METHODS: This is a retrospective study performed in 8 referral centers of MITO group. Data of women undergoing morcellation for apparent benign uterine myomas who were ultimately diagnosed with stage I uterine sarcoma on final pathology were compared with data of women who did not undergo morcellation. Uterine sarcoma included: leiomyosarcomas (LMS), smooth muscle tumors of uncertain malignant potential (STUMP), low-grade endometrial stromal sarcomas (LG-ESS) and undifferentiated uterine sarcomas (UUS)...
January 2017: Gynecologic Oncology
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