Iatrogenic endometriosis caused by uterine morcellation during a supracervical hysterectomy

BACKGROUND: Iatrogenic endometriosis is a rare complication associated with laparoscopic supracervical hysterectomy. CASE: A parous woman in her 30s underwent a laparoscopic supracervical hysterectomy for a leiomyomatous uterus. The uterus was amputated and removed from the abdominal cavity with an electric morcellator. She presented 6 months later complaining of cyclic pelvic pain. Diagnostic laparoscopy revealed endometrial implants in the pelvis. A laparoscopic trachelectomy, left salpingo-oophorectomy, and excision of endometrial implants was performed. She has since remained without symptoms. CONCLUSION: Spillage and implantation of viable endometrial tissue might occur during uterine morcellation during laparoscopic supracervical hysterectomy. This case emphasizes the importance of minimizing spillage and vigorous irrigation of the abdomen and pelvis before closing the incisions.