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Upcoming hysterectomy 12/1: Anybody know about morcellation
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11-28-2016, 08:09 AM
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HysterSister
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Posts: 65
Hysterectomy: December 1st, 2016
Surgery Type: DvH
Ovaries: Kept 1 or both
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Upcoming hysterectomy 12/1: Anybody know about morcellation
My surgery is in 3 days. Recently on the news they have been talking about power morcellation that that can spread undiagnosed cancer, taking it to immediate stage 4. Does every laproscopic surgery require morcellation if they are unable to vaginally remove uterus? I realize they are recalling the power morcellator but can't cutting up uterus into pieces possibly spread undiagnosed cancer cells?
Thanks for any info
EddyBetty
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11-28-2016, 09:03 AM
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Posts: 215
Hysterectomy: May 6th, 2016
Surgery Type: TAH
Ovaries: Removed both
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Re: Anybody know about morcellation
If a cancer is present then yes cutting up your uterus can spread cancer cells. And no every laparoscopic surgery does not require morcellation, usually your uterus (and possibly cervix) are extracted in whole through the vaginal incision. Often if the uterus is too big to remove in that manner (due to fibroids or other problems), the laparoscopic surgery is changed to an open abdominal procedure in the OR. I've read many posts where this was the case so you might want to discuss this possibility with your doctor and your concerns about the spread of a potential cancer.
Many doctors will not even use a morcellator anymore since their hypocratic oath requires that first and foremost they "do not harm". If your doctor is still using one I would consider seeking a second opinion.
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11-28-2016, 09:08 AM
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Posts: 18,968
Hysterectomy: May 16th, 2016
Surgery Type: LSH
Ovaries: Kept 1 or both
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Re: Anybody know about morcellation
I had laparo surgery and my uterus was morcellated - no bag used. I was a low-risk patient, and for low-risk patients the procedure can and is still used, though some doctors use a bag to contain the pieces. The issue with morcellation stems from a case where a woman has alleged that cancer was spread because of morcellation. You can read more at these two links:
Morcellation and Cancer Debate
Morcellation - Should I Be Worried?
As you see in the links, morcellation also benefits many women. It is true that morcellation is not recommended in the presence of documented or highly suspected malignancy. OTOH, the risk of uterine leiomyosarcoma (the type of cancer in question) is low, and for the majority of women it's not a major concern. I have not heard or read that morecellation leads to immediate Stage 4 , and I question the source - Stage 4 by definition occurs when cells have travelled through the bloodstream or lymph system.
Laparo surgery does not "require" morcellation. Laparo assisted surgery can also be completed by removing the organs vaginally. The other option is having a longer incision and having standard abdominal surgery.
This is something worth discussing with your doctor. Knowing what I know now... I'd still allow my uterus to be morcellated. I might insist on the environment being enclosed as a precautionary measure, but that's it. You will find support here for whatever decision you make!
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11-28-2016, 09:03 PM
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HysterSister
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Posts: 79
Hysterectomy: October 31st, 2016
Surgery Type: TLH
Ovaries: Kept 1 or both
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Upcoming hysterectomy 12/1: Anybody know about morcellation
I had a TLH hysterectomy on Oct 31 2016. I had a very large uterus and fibroids. Uterus and fibroids too large for vaginal removal. I also had a bag and manual morcellation. Doctors use a "C" incision to cut down the uterus with a scalpel. Most don't use power morcellation anymore. There are videos of actual surgeries on YouTube. If you are not sure you want to see the real thing, they have many animated versions too. I found it very helpful to understand exactly what they were going to do. I felt safe doing it with a bag and the "C" cutting technique after I researched it. Seeing it and understanding the risk made it easy for me to make my decision.
I hope this helps and wish you a speedy recovery.
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11-29-2016, 06:35 AM
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Posts: 8,056
Hysterectomy: April 14th, 2015
Surgery Type: LSH
Ovaries: Kept 1 or both
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Upcoming hysterectomy 12/1: Anybody know about morcellation
My surgeon had originally planned to do an LAVH for my fibroids, citing the cancer risk from morcellation, among other things. However, I was concerned that my 22-week uterus might not fit out through my small vagina, and I didn't like the idea of having my cervix removed. When I brought it up at our next appointment, he admitted that my risk was about 1/500, because I'd had the fibroids for 9 years, and so we settled on LSH, which turned out quite well. He did a closed morcellation, using a bag, and he had a biopsy done to ensure there was no cancer. Later, through talking to my family doctor, and reading other postings on this site, I realized that if we had stuck with LAVH, it may well have had to be converted to an abdominal procedure. I would recommend doing your own research - hopefully the articles Cussette recommended will help - and talk with your surgeon, so you can make the best decision for your individual situation. Best wishes for whatever you decide!
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