Long-term sequelae of unconfined morcellation during laparoscopic gynecological surgery

Although rare, unconfined morcellation of occult sarcoma has been associated with reduced survival rates. Morcellation of uterus and myoma can also lead to iatrogenic endometriosis, parasitic myoma and, albeit rarely, disseminated peritoneal leiomyomatosis. These benign sequelae of morcellation occur more often than malignant dissemination of sarcomatous tissue. Accordingly, confined morcellation should be performed with a minimally invasive technique while eliminating tissue dissemination inside the abdominal cavity. The ideal technique and device remain to be determined.