腟式細切により子宮を回収した電動モルセレーターを使用しないTLH後に発生した異所性子宮筋腫の1例

抄録

Background: The number of gynecological laparoscopic procedures is increasing. Power morcellation has been widely employed to break up large uterine fibroids and remove fragments from the abdominal cavity. In recent years, several studies have reported parasitic leiomyoma (PM), resulting from the spread and growth of fibroid tissues in the abdominal cavity after the use of power morcellation for laparoscopic hysterectomy or myomectomy.

Case: A 46-year-old para 1 woman had undergone total laparoscopic hysterectomy for a large uterine leiomyoma at the age of 41 without use of power morcellation. Fiftynine months later, she was found to have intrapelvic tumors. Following surgical resection they were diagnosed as iatrogenic PMs.

Conclusions: It is possible that iatrogenic PM can occur even if power morcellation is not used. Surgeons must be careful to remove as many small fragments of fibroids as possible. We should be aware of the risk for iatrogenic PMs in all surgical procedures for uterine fibroids. To our knowledge, this is the first report of a case of iatrogenic PM after total laparoscopic hysterectomy without the use of power morcellation.