Disseminated peritoneal leiomyomatosis: a devastating sequelae of unconfined laparoscopic morcellation.

Hwee Leong Tan; Ye Xin Koh; Min Hoe Chew; Junjie Wang; Jason Shau Khng Lim; Wei Qiang Leow; Ser Yee Lee

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Disseminated peritoneal leiomyomatosis: a devastating sequelae of unconfined laparoscopic morcellation.

Author: Hwee Leong TAN ¹ ; Ye Xin KOH ¹ ; Min Hoe CHEW ² ; Junjie WANG ³ ; Jason Shau Khng LIM ⁴ ; Wei Qiang LEOW ⁵ ; Ser Yee LEE ¹
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1. Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore.
2. Department of Colorectal Surgery, Singapore General Hospital, Singapore.
3. Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore.
4. Department of Obstetrics and Gynaecology, Singapore General Hospital, Singapore.
5. Department of Anatomical Pathology, Singapore General Hospital, Singapore.
Publication Type:Journal Article
Keywords: disseminated peritoneal leiomyomatosis; laparoscopic morcellation; parasitic leiomyoma
From:Singapore medical journal 2019;60(12):652-654
CountrySingapore
Language:English
Abstract: There has been growing concern surrounding the use of unconfined power morcellation in laparoscopic surgeries for uterine leiomyoma due to its associated risks and long-term clinical sequelae, including parasitic leiomyomas and disseminated peritoneal leiomyomatosis (DPL). We present a case of DPL resulting from previous laparoscopic morcellation and a review of the existing literature. DPL is a potentially devastating consequence of unconfined laparoscopic morcellation in the surgical management of uterine fibroids. A multidisciplinary approach is recommended in the management of DPL, especially in cases of multivisceral involvement. Clinical caution ought to be exercised when using power morcellators; when unavoidable, confined laparoscopic morcellation offers a promising mitigation and should be adopted if practicable.