The Royal College of Obstetricians and Gynaecologists has published consent advice and patient information for women offered a myomectomy or hysterectomy using morcellation, to reflect the latest emerging evidence.
The updated documents have been developed in collaboration with the Royal College of Radiologists, the Royal College of Pathologists, British Sarcoma Group, Sarcoma UK and the British Society for Gynaecological Endoscopy, following the establishment of a Morcellation Task and Finish Group by the RCOG in February 2019.
Women having a hysterectomy (an operation to remove their uterus) or a myomectomy (an operation to remove fibroids), may be offered a procedure called morcellation. Morcellation is when tissue such as the uterus or fibroids are cut into smaller pieces to allow them to be removed more easily. This can be done using an instrument called a morcellator.
The use of morcellation means the operation can be done laparoscopically (via keyhole surgery) or vaginally, leading to a quicker recovery than having open surgery. However, there are risks with morcellation including the chance that an undiagnosed cancer, called uterine sarcoma, can be spread during the surgery.
To enable women to make an informed choice about which surgery is right for them, these documents have been produced for healthcare professionals and patients, to encourage discussion of the individual risks of surgery, including the risks of morcellation.
The documents were made available for consultation and peer reviewed by healthcare professionals and by members of the RCOG Women’s Network, Women’s Voices Involvement Panel and by women and their families with close experience of this procedure.
Professor Hilary Critchley, Chair of the RCOG Task and Finish Group and Honorary Consultant in Obstetrics and Gynaecology at the University of Edinburgh, said:
“We are extremely grateful for the input and dedication from all the Task and Finish group members and reviewers throughout this complex process. The collaboration across organisational boundaries has been crucial to producing what we believe to be two important evidence based products to guide and support women making decisions about their hysterectomy or myomectomy treatment.”
Professor Lesley Regan, President of the Royal College of Obstetricians and Gynaecologists, said:
“We are enormously grateful to the Task and Finish Group and to all the organisations and individuals who have helped to review these revised products, and I would like to thank everyone who has been part of this process to date.
“This highly significant work has played a crucial role in ensuring that RCOG resources for women and clinicians are accurate and balanced, and ultimately support women to make informed choices about their care.
“The RCOG is committed to prioritising further guidance on uterine fibroids to ensure the evidence base informing care is as strong as it possibly can be, and based on the most robust and best available evidence to date.”
Notes to Editors
For media enquiries, please contact the RCOG press office on +44 (0)20 7045 6773 or email firstname.lastname@example.org
At the request of the RCOG President, the Morcellation Task and Finish Group was established in early 2019 and the initial meeting was held at the RCOG on 13 February 2019. The remit of the group was to review the RCOG Patient Information on ‘Morcellation for laparoscopic hysterectomy’ and ‘Morcellation for laparoscopic myomectomy in line with the latest evidence base and to address any shortfalls in the patient consent document that are relevant to these procedures.
The revised documents are:
RCOG Consent Advice No. 13: Morcellation for myomectomy or hysterectomy
Information for You: Morcellation for myomectomy or hysterectomy
About the RCOG
The Royal College of Obstetricians and Gynaecologists is a medical charity that champions the provision of high quality women’s healthcare in the UK and beyond. It is dedicated to encouraging the study and advancing the science and practice of obstetrics and gynaecology. It does this through postgraduate medical education and training and the publication of clinical guidelines and reports on aspects of the specialty and service provision. www.rcog.org.uk