Single-site in-bag morcellation achieved via direct puncture of the pneumoperitoneum cap, a cordless electric morcellator, and a 5-mm flexible scope

Eur J Obstet Gynecol Reprod Biol. 2016 Jun;201:126-30. doi: 10.1016/j.ejogrb.2016.04.012. Epub 2016 Apr 13.

Abstract

Objective: To evaluate a modified single-access method of contained power morcellation performed with a single-access laparoscopic device and a new cordless electric morcellator. The study was a preliminary assessment of the feasibility and safety of the new technique.

Study design: A single university hospital observational study involving patients who underwent either laparoscopic myomectomy or laparoscopic hysterectomy. We evaluated the operative results, time required for the contained morcellation, any occurrence of bag leakage, and any complications.

Results: The new contained power morcellation technique was applied in 12 patients (9 undergoing laparoscopic myomectomy and 3 undergoing laparoscopic hysterectomy). The mean bag introduction time was 21.8min (range, 14-37min); mean in-bag morcellation time was 11.5min (range, 1-26min); and mean total morcellation time was 36.8min (range, 19-66min). Visual inspection revealed no bag damage. There were no postoperative complications.

Conclusion: Single-site in-bag morcellation performed with our new technique requires neither bag penetration nor piercing with a trocar and thus may prove beneficial for preventing spillage and dissemination of unwanted cells and tissue.

Keywords: Laparoscopic myomectomy; Port-site metastasis; Power morcellation.

MeSH terms

  • Adult
  • Female
  • Humans
  • Hysterectomy / instrumentation
  • Hysterectomy / methods*
  • Laparoscopy / instrumentation
  • Laparoscopy / methods*
  • Middle Aged
  • Morcellation / instrumentation
  • Morcellation / methods*
  • Treatment Outcome
  • Uterine Myomectomy / instrumentation
  • Uterine Myomectomy / methods*
  • Uterus / surgery*