SLIDE 7 ¥ FDA Warning issued 4/17/2014! ¥ Prevalence of unsuspected uterine sarcoma in patients
undergoing hysterectomy or myomectomy for presumed benign Þbroids is 1 in 352, and the prevlance of unsuspected uterine leiomyosarcoma is 1 in 498.!
¥
ÒIf laparoscopic power morcellation is performed in women with unsuspected uterine sarcoma, there is a risk that the procedure will spread the cancerous tissue within the abdomen and pelvis, signiÞcantly worsening the patientÕs likelihood of long-term
- survival. For this reason, and because there is no reliable method for predicting
whether a woman with Þbroids may have a uterine sarcoma, the FDA
discourages the use of laparoscopic power morcellation during hysterectomy for uterine Þbroids.Ó
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ACOG
ÒMinimally invasive surgery, including with power morcellation, continues to be an option for some patients when performing hysterectomy and
- myomectomy. At the same time, it is
critical to minimize the risk for patients undergoing these surgeries who may have an occult gynecologic cancer.Ó
Specimen Removal:
Vaginal route
¥ Great option for TLH! ¥ Less practical for a very large uterus or
patient with narrow pubic arch!
¥ Not an option for LSH!
! !
