In-Bag Morcellation as a Routine for Laparoscopic Hysterectomy

Tissue morcellation during laparoscopic hysterectomy carries the risk of spreading cells from unsuspected malignancy. Contained morcellation inside a bag is supposed to minimize this risk. The present study evaluated routine use of in-bag morcellation during laparoscopic hysterectomy in a consecutiv...

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Bibliographic Details
Published in:BioMed research international 2017-01, Vol.2017 (2017), p.1-6
Main Authors: Rimbach, Stefan, Schempershofe, Miriam
Format: Article
Language:English
Subjects:
Archives & records
Bleeding
Body mass
Clinical Study
Fibroids
Gynecology
Hysterectomy
Laparoscopy
Malignancy
Methods
Muscles
Obstetrics
Patients
Peritoneum
Smooth muscle
Surgical techniques
Uterus
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Summary:Tissue morcellation during laparoscopic hysterectomy carries the risk of spreading cells from unsuspected malignancy. Contained morcellation inside a bag is supposed to minimize this risk. The present study evaluated routine use of in-bag morcellation during laparoscopic hysterectomy in a consecutive patient cohort (n=49). The system used was More-Cell-Safe (A.M.I. Austria). Median age was 47 (35 to 76) years and BMI 25.1 (18.8 to 39.8). Indications for hysterectomy were fibroids (71.4%), adenomyosis (16.3%), prolapse (8.2%), and bleeding disorders (4.1%). 48 (98%) patients underwent supracervical hysterectomy and 1 (2%) underwent total hysterectomy. No unsuspected malignancy occurred. Median weight of extirpated tissue was 195 g (18 to 1110). Residual tissue and/or fluid in the bag amounted to 29 g (0 to 291). Median overall duration of surgeries was 100.5 min, and median time associated with the use of the bag was 10 min (5 to 28), significantly correlated with uterine volume (p=0.0094) and specimen weight (p=0.0002), but not with patient’s BMI (p=0.6970). Technical success rate for contained morcellation was 93.9%. Peritoneal washings after contained morcellation were all negative for malignant or smooth muscle cells.
ISSN:2314-6133
2314-6141
DOI:10.1155/2017/6701916