title: A critical assessment of morcellation and its impact on gynecologic surgery and the limitations of the existing literature.
abstract: Uterine sarcomas are rare uterine malignancies that are difficult to diagnose preoperatively. Because of cases of disseminated sarcoma after laparoscopic hysterectomy, the role of power morcellators in gynecologic surgery has been questioned. Morcellation is an integral part of making laparoscopic surgery possible for the removal of large uterine leiomyomata, and the development of power morcellation has increased efficiency during these procedures. Minimally invasive surgery has demonstrated benefits that include improved pain control, decreased infection risk, and faster surgical recovery and return to work. In this review, we examine the risk of incidental sarcoma at the time of surgery, the quality of the data, the accuracy of clinical and radiologic predictors of uterine sarcoma, and the impact of morcellation on the prognosis of uterine sarcoma.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of California, Irvine Medical Center, Orange, CA. Electronic address: fongl1@uci.edu.
authors.forename: Fong W
authors.initials: FW
authors.lastname: Liu
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of California, Irvine Medical Center, Orange, CA.
authors.forename: Valerie B
authors.initials: VB
authors.lastname: Galvan-Turner
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of California, Irvine Medical Center, Orange, CA.
authors.forename: Krista S
authors.initials: KS
authors.lastname: Pfaendler
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of California, Irvine Medical Center, Orange, CA.
authors.forename: Teresa C
authors.initials: TC
authors.lastname: Longoria
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of California, Irvine Medical Center, Orange, CA.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Bristow
mesh_terms: D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D012509:Sarcoma / Q000175:diagnosis / Q000601:surgery*; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000601:surgery*
keywords: minimally invasive surgery; morcellation; uterine sarcoma