Morcellation of a Uterus Problems | Medical Algorithm

While laparoscopic supracervical hysterectomy with morcellation is minimally invasive, it can also spread a malignant uterine tumor.

Issues have been most often reported for endometrial adenocarcinoma but could also involve endocervical adenocarcinoma or myometrial sarcomas.

Problems can arise from:

(1) failure to adequately sample the endometrium prior to the procedure (endometrial sampling may miss a myometrial sarcoma)

(2) failure to collect fragments into a plastic laparoscopy bag as released (this takes more time and slows down the procedure)

(3) failure to collect all of the fragments from the procedure (residual fragments can cause spread of the tumor within the peritoneal cavity)

(4) sampling error from highly fragmented tissue causing a small tumor to be missed

(5) incorrect staging of a tumor due to highly fragmented tissue that is difficult to orient

(6) inadequate follow-up of the patient

To read more or access our algorithms and calculators, please log in or register.

Problems Associated with Morcellation of Uterus with Unexpected Malignancy