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In The News – Laparoscopic Uterine Surgery

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The instrument used in robotic surgery has been in the news lately linked to a vary rare type of cancer. Dr. Barbie Sullivan has written the piece below to try to make some sense out of the reports, put the facts in perspective, and alleviate unnecessary fears:

The instrument used in robotic surgery has been in the news lately linked to a vary rare type of cancer. Dr. Barbie Sullivan has written the piece below to try to make some sense out of the reports, put the facts in perspective, and alleviate unnecessary fears:

You hear a lot in the news lately about morcellation and its use in gynecologic surgery. Morcellation along with laparoscopic surgery has made it possible for gynecologists to remove larger fibroids (benign tumors of the uterus) and larger uteruses through tiny incisions. This means that patients do not have big incisions on the abdomen, usually go home within 24 hours of surgery and have a shorter recovery and return to normal activities. Unfortunately, like with most medical decisions we make there are risks involved with these procedures.

Rarely, fibroids will have some cells in them that undergone cancerous changes called a sarcoma. It is estimated that 1 in 1,000 women undergoing surgery for fibroids will have this and it is very difficult to identify before surgery. If morcellation is used to remove this tissue then there is the possibility that the cancerous cells can be spread throughout the abdominal cavity spreading the disease.

It is important to that patients discuss surgical options and risks with their physician before surgery to decide what procedure is best for their individual case. A large incision on the abdomen reduces the risk of spreading the cancerous cells but increases risks associated with surgery and recovery. It also means a longer recovery time.

Minimally invasive surgery for larger fibroids may mean increased risk of spreading these rare cancerous cells but decrease surgery risks and recovery time. As with most technology we are striving to improve morcellation and may one day be able to perform this procedure in a “bag” to prevent spreading the cells in the abdominal cavity. There is also work being done to help with identification of sarcomas preoperatively

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