Disseminated peritoneal leiomyomatosis: a devastating sequelae of unconfined laparoscopic morcellation

Hwee Leong Tan1, Ye Xin Koh1, Min Hoe Chew2,3,4

  • 1Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore.

Insights

Unconfined power morcellation during laparoscopic surgery for uterine fibroids can lead to disseminated peritoneal leiomyomatosis (DPL). Confined morcellation is a safer alternative to mitigate this risk.

Area of Science:

  • Gynecologic surgery
  • Surgical pathology

Background:

  • Growing concerns exist regarding unconfined power morcellation in laparoscopic surgery for uterine leiomyoma.
  • Associated risks include parasitic leiomyomas and disseminated peritoneal leiomyomatosis (DPL).

Observation:

  • This report details a case of DPL following laparoscopic morcellation.
  • A review of current literature on DPL is presented.

Findings:

  • Disseminated peritoneal leiomyomatosis (DPL) is a severe potential outcome of unconfined laparoscopic morcellation for uterine fibroids.
  • Management of DPL, particularly with multivisceral involvement, necessitates a multidisciplinary approach.

Implications:

  • Clinical use of power morcellators requires caution.
  • Confined laparoscopic morcellation should be adopted when feasible to reduce DPL risks.

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