Uterine fibroids morcellation: a puzzle topic

• Published in: Minimally invasive therapy and allied technologies Vol. 31; no. 7; pp. 1008 - 1016
• Main Authors: Mercorio, Antonio, Della Corte, Luigi, Vetrella, Martino, Russo, Mario, Serafino, Paolo, Palumbo, Mario, Viciglione, Francesco, Cafasso, Valeria, Bifulco, Giuseppe, Giampaolino, Pierluigi
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 03.10.2022
• Subjects: contained morcellation; Female; fibroid; Humans; Hysterectomy - methods; laparoscopy; Laparoscopy - methods; Leiomyoma - surgery; Manual morcellation; Morcellation - adverse effects; Morcellation - methods; occult sarcoma; parasitic myoma; power morcellation; Sarcoma - surgery; Uterine Myomectomy - methods; Uterine Neoplasms - surgery; laparoscopy; contained morcellation; fibroid; Manual morcellation; occult sarcoma; power morcellation; parasitic myoma
• ISSN: 1364-5706; 1365-2931; 1365-2931
• DOI: 10.1080/13645706.2022.2095872

The laparoscopic approach for the treatment of uterine leiomyoma is increasingly practiced. The necessity to remove large specimens from the small laparoscopic incision has always been one of the main limits of this procedure. The unrestricted use of morcellation, to overtake this weak point of minimally invasive surgery, has opened in recent years a broad debate, especially on the risk of unintended dissemination of cells that could in some cases lead to extremely negative repercussions. This review analyzes these aspects and the principal recommendations from the major gynecological society on this topic surveying their effects. Furthermore, the purpose of this article is to provide an overview of the different morcellation techniques and how they are performed, evaluating their advantages and disadvantages. Contained morcellation seems to overcome many limits; however, based on recent data, an appropriate evaluation and selection of patients, as well as complete counseling before the surgery, are mandatory.