Dr. Shibley helps make removal of uterine specimens safer for patients
A new technique makes laparoscopic removal of uterine specimens safer for women, thanks to a collaboration involving K. Anthony Shibley, MD, of OBGYN Specialists.
Shibley worked with a group from John’s Hopkins, Brigham and Women’s Hospital, and Massachusetts General Hospital on the technique known as “contained uterine morcellation.” Results of the study appeared in the September 2014 issue of Obstetrics and Gynecology: “Contained Power Morcellation Within an Insufflated Isolation Bag”
“Uterine morcellation has been around since 1993,” says Shibley, “but until now, specimens were morcellated inside the abdomen in an uncontained way. We found a way to contain the procedure and make it safer.”
During “open” morcellation, the physician inserts a circular tube with a sharp, spinning end into the abdomen. The physician guides an instrument down the tube to grab tissue and remove it through the small incisions.
“Uterine morcellation is appropriate for women needing a hysterectomy where the specimen is too large to be removed through the incision or vaginally,” Shibley says. “We also can remove fibroids this way. Most patients go home the same day and are back to work in one or two weeks.”
While the procedure is generally safe, during “open” morcellation, tissue fragments may remain behind, causing infection, pain and the need for further surgery. The “open” procedure can scatter undiagnosed malignant or even non-cancerous tissue that could spread and grow. In addition, the spinning blade could damage surrounding organs, such as the intestines.
Three years ago, Dr. Shibley began working on a procedure in which he puts instruments inside a bag he then inflates inside the abdomen. The bag contains the procedure and resulting tissue fragments. His colleagues at OBGYN Specialists began using the procedure two years ago.
Last spring, a study of 73 patients showed “there were no complications related to the contained morcellation technique nor was there visual evidence of tissue dissemination outside of the isolation bag,” according to the Obstetrics and Gynecology article.
Dr. Shibley and his partners since have performed the minimally invasive technique on more than 200 patients, and Dr. Shibley has trained other local physicians on the procedure. In 2015, a new device will become available to streamline the process and make the technique simpler.