Larger incisions to remove fibroids


Dr. Kelli Beingesser by Dr. Hasan Abdessamad - Gynecologist Vancouver Dr. Kelli Beingesser presented today about Laparoscopic myomectomy and power morcellation at the Laparoscopic Institute for Gynecology & Oncology (LIGO) Surgical Masters’ Course in San Francisco.

Here are few points she brought up about power morcellation and sarcomas:

  1. Most womyn with sarcoma are postmenopausal.

  2. Imaging can not diagnose sarcoma, but a single mass with poor margins and rapid growth should raise suspicion.

  3. If sarcoma is morcellated, the recurrence is higher and survival rate is lower.

  4. Power morcellation should be avoided if there is doubt or suspicion of the presence of sarcoma.

  5. Alternatively, morcellation within a bag can be performed in cases where a sarcoma might be suspected.

It is worth noting that Johnson&Johnson has already pulled their power morcellator of the shelves.

A simple Google search for “morcellation lawsuit” brings up a plethora of ads and posts by lawyers and law firms as Dr. Beingesser pointed out today.

Given the above, alternatives to power morcellation will be sought. This could be via placing the fibroid or uterus in a leak-proof bag and trying to morcellate vaginally or abdominally at the expense of: 1> a larger skin incision, 2> a longer operative time, 3> a steeper learning curve, 4> less surgeons pursuing minimally invasive surgery for fibroids.

Dr. Hasan Abdessamad precepting Dr. Ahmad Hasan - Vancouver Gynecologist Hysterectomy

Here is what LIGO faculty: Dr. Kelli Beingesser (California), Dr. Francisco Garcini (Illinois) and Dr. Samar Nahas (Ontario) had to say about power morcellation and how the FDA statement impacted their practice:

Here is what Dr. Kate O’Hanlan, LIGO founder and chairwoman, said:

This video has been added after Dr. Hooman Noorchashm’s comment below:



Categories: Gynecology, Health

Tags: , , , , , , , , ,

3 replies

  1. The five points raised by Dr. Beingesser have absolutely no basis in clinical or scientific fact. They are empiric, defensive and dangerous positions, which I suppose are necessary in a forum such as LIGO’s Surgical Masters’ course.

    I also watched the video at the end of this blog and was puzzled.

    I am puzzled. How is morcellating a patient’s occult and undiagnosable sarcoma the patient’s choice?
    I am puzzled. How is morcellation in a bag safe, when the sharp blades of a morcellator or knife can easily pierce through the plastic bag?
    I am puzzled. How can a surgeon, now knowing that a one in 350 risk of an occult sarcoma, change nothing and “follow AAGL guidelines”?
    This specialty stands guilty of industry-wide neglect, and of choosing revenue and business over patient safety and ethics.
    This practice is dead wrong and many of the one in 350 victimized for nearly two decades are very much dead.
    It is time to stop and for professional ethics and minds to start working properly.
    Hooman Noorchashm MD, PhD
    Boston, MA.

    Like

    • Thank you Dr. Noorchashm for the comment and I am sorry to learn about the outcome of your wife. You both raise great points in this video

      so I will update my blog post with it as I am sure many will appreciate that.

      Like

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