Severe direct and indirect complications of morcellation after hysterectomy or myomectomy

Gitas, Georgios; Alkatout, İbrahim; Allahqoli, Leila; Rody, Achim; Ertan, A. Kubilay; Grimbizis, Grigoris; Baum, Sascha

doi:10.1080/13645706.2020.1802292

Cited by 8 publications

(4 citation statements)

References 37 publications

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“…The well‐known advantages of minimally invasive surgery, such as shorter hospital stays, less blood loss, less de novo adhesions and lower patient morbidity compared to open procedures, have been observed in robotic assisted surgery as well 4–7 . Three‐dimensional technology, improved dexterity up to 7 degrees of freedom and tremor‐free handling permit better exposure of the operating field in complex cases 4 .…”

Section: Introductionmentioning

confidence: 99%

Surgical outcomes of conventional laparoscopic and robotic‐assisted hysterectomy

Gitas

Alkatout

Proppe

et al. 2021

Robotics Computer Surgery

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Introduction The aim of the present study was to compare surgical outcomes of total laparoscopic hysterectomy with those of the robotic approach using the da Vinci Xi system. Methods Patients who underwent hysterectomy with da Vinci Xi for early endometrial cancer or benign indications from 2018 to 2019 were selected. The control group consisted of patients who underwent conventional laparoscopy. Results A total of 300 patients were included in the study. The mean duration of surgery differed significantly (p = 0.025) between those who underwent laparoscopy (125.01 ± 76.168) and robotic‐assisted surgery (142.96 ± 82.657 min). Blood loss, median hospital stay, intraoperative and postoperative complications were similar in both groups. No statistical difference was observed in the subgroups with a body mass index of more than 30 kg/m2 or more than 40 kg/m2 concerning the duration of surgery or the surgical outcome. Conclusion The da Vinci Xi did not improve surgical outcomes in patients who underwent hysterectomy by trained laparoscopists and takes more time than conventional laparoscopy when performed in patients of normal weight.

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Section: Introductionmentioning

confidence: 99%

Surgical outcomes of conventional laparoscopic and robotic‐assisted hysterectomy

Gitas

Alkatout

Proppe

et al. 2021

Robotics Computer Surgery

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“…Some authors suggest that the laparoscopic approach should be avoided in cases involving more than four fibroids in different sites of the uterus requiring numerous incisions, in cases of large fibroids (larger than 10–12 cm) or if fibroids are located in an intraligamental location [ 67 ]. Others have recommended that for the laparoscopic approach, a uterus has to be smaller than the size of 16 gestational weeks, with less than five fibroids, whereby no fibroid should be greater than 15 cm [ 78 ]. A diameter of the člargers myome of 12 cm or more significantly increases the occurrence of surgical complications.…”

Section: Resultsmentioning

confidence: 99%

“…In the case of multiple myomas, laparoscopic myomectomy can be performed in several stages. Large fibroids can be safely and effectively treated combining uterine artery embolization as a first step and laparoscopic myomectomy (performed either on the same day or couple of days later) as the second therapeutic step [ 67 , 78 ].…”

Section: Resultsmentioning

confidence: 99%

Currently Available Treatment Modalities for Uterine Fibroids

Micić,

Macura,

Andjić

et al. 2024

Medicina

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Uterine fibroids (leiomyomas and myomas) are the most common benign gynecological condition in patients presenting with abnormal uterine bleeding, pelvic masses causing pressure or pain, infertility and obstetric complications. Almost a third of women with fibroids need treatment due to symptoms. Objectives: In this review we present all currently available treatment modalities for uterine fibroids. Methods: An extensive search for the available data regarding surgical, medical and other treatment options for uterine fibroids was conducted. Review: Nowadays, treatment for fibroids is intended to control symptoms while preserving future fertility. The choice of treatment depends on the patient’s age and fertility and the number, size and location of the fibroids. Current management strategies mainly involve surgical interventions (hysterectomy and myomectomy hysteroscopy, laparoscopy or laparotomy). Other surgical and non-surgical minimally invasive techniques include interventions performed under radiologic or ultrasound guidance (uterine artery embolization and occlusion, myolysis, magnetic resonance-guided focused ultrasound surgery, radiofrequency ablation of fibroids and endometrial ablation). Medical treatment options for fibroids are still restricted and available medications (progestogens, combined oral contraceptives andgonadotropin-releasing hormone agonists and antagonists) are generally used for short-term treatment of fibroid-induced bleeding. Recently, it was shown that SPRMs could be administered intermittently long-term with good results on bleeding and fibroid size reduction. Novel medical treatments are still under investigation but with promising results. Conclusions: Treatment of fibroids must be individualized based on the presence and severity of symptoms and the patient’s desire for definitive treatment or fertility preservation.

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“…Surgery is the primary treatment for patients with early endometrial cancer ( 5 ). Various studies have shown that the advantages of laparoscopic surgery over open surgery include a lower rate of postoperative adhesions, a shorter hospital stay, fewer postoperative complications, less pain, and better quality of life due to faster recovery ( 6 , 7 , 8 , 9 , 10 , 11 ). Furthermore, several studies have concluded that minimally invasive surgery provides similar oncological outcomes and is associated with lesser morbidity compared to laparotomy ( 12 , 13 ).…”

Section: Introductionmentioning

confidence: 99%

Surgical treatment of endometrioid endometrial carcinoma - laparotomy versus laparoscopy

Baum¹,

Alkatout²,

Proppe³

et al. 2022

J Turkish German Gynecol Assoc

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Objective: Recent publications have raised doubts about the oncological safety of a laparoscopic approach in the treatment of endometrial cancer. The aim of this study was to investigate the beneficial aspects of laparoscopy versus laparotomy in patients with endometrial cancer, and present oncological outcomes. Material and Methods: A retrospective study of patients who underwent surgery for the treatment of endometrioid endometrial cancer was performed. Surgical outcomes and complications in patients who were treated by laparoscopy or open surgery were compared. The patients were followed for 5-years. Patients’ characteristics, tumor stage, complications rate and oncologic outcome were analyzed. Results: A total of 151 patients were included. The laparoscopy (n=80) and laparotomy (n=71) groups were homogeneous in regards of demographic data and tumor stage. Median average blood loss (1.31 vs. 1.92 g/dL), the mean duration of hospitalization (5.73 vs. 12.25 days), intraoperative (0 vs. 6%), and severe postoperative complications (5.1 vs. 14.3%) were significantly lower in the laparoscopy group. The numbers of pelvic or para-aortic lymph nodes removed during systematic lymphadenectomy were similar in both groups. Women who underwent laparoscopy and those who underwent laparotomy had similar five-year recurrence-free survival rates (88.7% vs. 91.5%, p=0.864), as well as similar overall five-year survival rates (91.2% vs. 97.2%, p=0.094). Conclusion: The oncological outcome of laparoscopy was similar to that of laparotomy in the treatment of patients with endometrial cancer. However, surgical outcomes and morbidity rates were significantly better in patients treated by laparoscopy. Clinical trials are essential to evaluate the oncological efficacy of laparoscopy in patients with endometrial cancer.

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Severe direct and indirect complications of morcellation after hysterectomy or myomectomy

Cited by 8 publications

References 37 publications

Surgical outcomes of conventional laparoscopic and robotic‐assisted hysterectomy

Surgical outcomes of conventional laparoscopic and robotic‐assisted hysterectomy

Currently Available Treatment Modalities for Uterine Fibroids

Surgical treatment of endometrioid endometrial carcinoma - laparotomy versus laparoscopy

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