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Laparoscopic morcellator-related complications.

Magdy P Milad1, Elizabeth A Milad1

  • 1Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

Journal of Minimally Invasive Gynecology
|December 17, 2013
PubMed
Summary
This summary is machine-generated.

Laparoscopic morcellation for tissue removal has risks, including organ injury and death. Most complications are underreported and linked to surgeon inexperience, highlighting the need for safer practices.

Keywords:
Blue EndoFibroidsLaparoscopicLaparoscopyLeiomyomaLeiomyomataMOREsolutionMorcellationMorcellatorMorcellexParasiticPlasmaSORDPowerplusRetainedRotocutSAWALHESteinerX-Tract

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Area of Science:

  • Minimally Invasive Surgery
  • Surgical Complications
  • Medical Device Safety

Background:

  • Laparoscopic morcellation is a common technique for removing bulky abdominal tissue.
  • Despite its utility, morcellator-related injuries and complications are underreported and poorly understood.
  • Existing literature often fails to capture the full scope of adverse events.

Purpose of the Study:

  • To systematically review morcellator-related injuries and near misses in the United States.
  • To update the understanding of complications associated with powered tissue removal during laparoscopy.
  • To identify factors contributing to morcellator-related adverse events.

Main Methods:

  • Systematic review of US surgical centers and literature from 1993-2013.
  • Inclusion of data from MedSun and the FDA MAUDE database.
  • Searches using specific keywords and morcellator model names.

Main Results:

  • Identified 55 complications over 15 years, including injuries to bowels, vascular system, and other organs.
  • Most complications (66%) were identified intraoperatively, but some were noted up to 10 days postoperatively.
  • Surgeon inexperience was a key factor in ascribed causes; six deaths were linked to morcellator use.

Conclusions:

  • Laparoscopic morcellators offer significant benefits for minimally invasive procedures.
  • There is a substantial incidence of unreported intraoperative complications associated with morcellation.
  • Enhanced surgeon training and adherence to safe practices are crucial to mitigate iatrogenic injuries.