Disseminated peritoneal leiomyomatosis: a devastating sequelae of unconfined laparoscopic morcellation

Singapore Med J. 2019 Dec;60(12):652-654. doi: 10.11622/smedj.2019159.

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.

Keywords: disseminated peritoneal leiomyomatosis; laparoscopic morcellation; parasitic leiomyoma.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Disease Progression
  • Female
  • Humans
  • Hysterectomy
  • Laparoscopy / adverse effects*
  • Leiomyoma / complications
  • Leiomyoma / surgery*
  • Leiomyomatosis / complications*
  • Morcellation / adverse effects*
  • Peritoneal Neoplasms / complications*
  • Tomography, X-Ray Computed
  • Uterine Neoplasms / complications
  • Uterine Neoplasms / surgery*