Clinical Use of the Intrauterine Morcellator: A Single Academic Center’s Experience

Stephanie Rothenberg, Shweta Nayak, Joseph S. Sanfilippo

University of Pittsburgh Medical Center, Magee―Women’s Hospital, Pittsburgh, USA.

DOI: 10.4236/ojog.2014.46049                

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 at Magee―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.

Keywords

Intrauterine Morcellator; Morcellation; Operative Hysteroscopy; Myomectomy; Polypectomy

Conflicts of Interest

The authors declare no conflicts of interest.

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