Laparoscopic Resection of Parasitic Fibroids after Hysterectomy

Abstract

<h3>Study Objective</h3> The purpose of this video is to demonstrate resection of parasitic fibroids after hysterectomy. <h3>Design</h3> Case Presentation. <h3>Setting</h3> Academic affiliated community hospital. <h3>Patients or Participants</h3> 47yo G3P3 with history of uterine fibroids, status post laparoscopic supracervical hysterectomy and bilateral salpingectomy, who re-presented after eight years with abdominal pain. Review of prior surgical operative report revealed that mechanical morcellation was perform at the left lower quadrant trocar site. On imaging, patient was found to have multiple intra-abdominal masses and a 4 cm abdominal wall mass. <h3>Interventions</h3> Laparoscopic resection of fibroids and radical resection of soft tissue mass <h3>Measurements and Main Results</h3> Intraoperative frozen section and final pathology was consistent with leiomyoma. The patient tolerated the procedure well and was discharged approximately 3 hours after her procedure. <h3>Conclusion</h3> Iatrogenic parasitic leiomyomas can occur after uterine morcellation. This risk is increased if mechanical morcellation is performed. Thorough inspection and washing of the abdominopelvic cavity postoperatively can decrease risk of occurrence.