A nationwide survey of the use of the laparoscopic power morcellator

• Published in: The journal of obstetrics and gynaecology research Vol. 49; no. 2; pp. 682 - 690
• Main Authors: Hiraike, Osamu, Koga, Kaori, Taniguchi, Fuminori, Harada, Tasuku, Takeshita, Toshiyuki, Shiota, Mitsuru, Osuga, Yutaka
• Format: Journal Article
• Language: English
• Published: Kyoto, Japan John Wiley & Sons Australia, Ltd 01.02.2023; Wiley Subscription Services, Inc
• Subjects: Cross-Sectional Studies; Diagnosis; dissemination; Female; Fibroids; Humans; Hysterectomy; laparoscopic myomectomy (LM); laparoscopic power morcellator; Laparoscopy; Laparoscopy - methods; Leiomyoma - pathology; Leiomyoma - surgery; Magnetic resonance imaging; Malignancy; Surgery; Surveys; Surveys and Questionnaires; uterine fibroid; Uterine Myomectomy - methods; Uterine Neoplasms - pathology; Uterine Neoplasms - surgery; Uterus; Japan; laparoscopic myomectomy (LM); uterine fibroid; malignancy; laparoscopic power morcellator; dissemination
• ISSN: 1341-8076; 1447-0756
• DOI: 10.1111/jog.15492

Aim Laparoscopic power morcellator (LPM) can be used for tissue retrieval through laparoscopic port site, but the dissemination of uterine and/or myoma tissues is a serious complication. To study the use of LPM for uterine fibroid treatment in Japan, we aimed to perform two national cross‐sectional surveys comprising multiple questionnaires. Methods The first survey (2011–2013) was conducted in November 2014, and 203 medical institutions responded. The second survey (2017–2019) was conducted in December 2020, and 302 medical institutions were investigated. Results Overall, 72 104 and 120 425 surgeries and 0.04% and 0.05% cases of postoperative malignancy diagnosis were reported in the first and second surveys, respectively. Magnetic resonance imaging was performed in >90% of the cases in the first and second surveys as preoperative examinations. The frequency of LPM at hysterectomy was 8.9% and 4.6% and the frequency of LPM at laparoscopic myomectomy was 80.4% and 54.8% in the first and second surveys, respectively; both the parameters decreased in the second survey. Conclusions It is impossible to completely exclude malignant diseases even if extensive preoperative diagnosis has been done before surgery. Therefore, the use of LPM in patients requires careful attention and informed consent in Japan.