TITLE:
Clinical Use of the Intrauterine Morcellator: A Single Academic Center’s Experience
AUTHORS:
Stephanie Rothenberg, Shweta Nayak, Joseph S. Sanfilippo
KEYWORDS:
Intrauterine Morcellator; Morcellation; Operative Hysteroscopy; Myomectomy; Polypectomy
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.4 No.6,
April
24,
2014
ABSTRACT:
Objective: To reveal the
breadth of experience for the intrauterine morcellator amongst gynecologists in
a single US academic center. Design: Retrospective Descriptive. Setting:
University Hospital. Patients: In total, 33 hysteroscopic procedures, with
intrauterine morcellation, were performed for 28 patients for benign
endometrial disease atMagee―Womens
Hospital at the University of Pittsburgh Medical center between October 2006
and February 2012. Intervention: Operative Hysteroscopy with an intrauterine
morcellator. Measurement and Main Results: The major indication for
hysteroscopic surgery was endometrial polyp (54.5%), followed by intrauterine
fibroids (18.2%), filling defect on sonohysterogram (15.2%), abnormal uterine
bleeding (9.1%), and uterine synechiae (3%). The mean greatest diameter for all
intrauterine pathology resected was 1.14 ± 0.46 cm (Range 0.6 - 1.9 cm), and,
notably, the largest fibroid resected was 1.5 cm in greatest diameter. The
average operative time was 39 ± 29 minutes (range 15 - 122 minutes), and
average hysteroscopic fluid deficit was 286 ± 479.5 mL (range 30 - 2000 mL).
There were only 2 patients for whom the deficit was greater than 1 L, one of
whom underwent a myomectomy with total operative time of 26 minutes, while the
other underwent a hysteroscopic adhesiolysis and had a total operative time of
122 minutes. The complication rate was 6.0%, and complications reported
included uterine perforation (n = 1) and cervical injury (n = 1). Conclusion:
The intrauterine morcellator is a useful tool for surgical treatment of
intrauterine pathology that confers a low operative risk.