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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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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Schempershofe, Miriam
description 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.
doi_str_mv 10.1155/2017/6701916
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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.</description><identifier>ISSN: 2314-6133</identifier><identifier>EISSN: 2314-6141</identifier><identifier>DOI: 10.1155/2017/6701916</identifier><identifier>PMID: 29318153</identifier><language>eng</language><publisher>Cairo, Egypt: Hindawi Publishing Corporation</publisher><subject>Archives &amp; records ; Bleeding ; Body mass ; Clinical Study ; Fibroids ; Gynecology ; Hysterectomy ; Laparoscopy ; Malignancy ; Methods ; Muscles ; Obstetrics ; Patients ; Peritoneum ; Smooth muscle ; Surgical techniques ; Uterus</subject><ispartof>BioMed research international, 2017-01, Vol.2017 (2017), p.1-6</ispartof><rights>Copyright © 2017 Stefan Rimbach and Miriam Schempershofe.</rights><rights>COPYRIGHT 2017 John Wiley &amp; Sons, Inc.</rights><rights>Copyright © 2017 Stefan Rimbach and Miriam Schempershofe.; This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</rights><rights>Copyright © 2017 Stefan Rimbach and Miriam Schempershofe. 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c565t-f1ba1eb82073a5eba6eff842ad2460baee50dd3c74b99a088c865e684da408333</citedby><cites>FETCH-LOGICAL-c565t-f1ba1eb82073a5eba6eff842ad2460baee50dd3c74b99a088c865e684da408333</cites><orcidid>0000-0002-5493-6563</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/1976025914/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/1976025914?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,25753,27924,27925,37012,37013,44590,75126</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29318153$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Tanos, Vasilis</contributor><creatorcontrib>Rimbach, Stefan</creatorcontrib><creatorcontrib>Schempershofe, Miriam</creatorcontrib><title>In-Bag Morcellation as a Routine for Laparoscopic Hysterectomy</title><title>BioMed research international</title><addtitle>Biomed Res Int</addtitle><description>Tissue morcellation during laparoscopic hysterectomy carries the risk of spreading cells from unsuspected malignancy. 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subjects Archives & records
Bleeding
Body mass
Clinical Study
Fibroids
Gynecology
Hysterectomy
Laparoscopy
Malignancy
Methods
Muscles
Obstetrics
Patients
Peritoneum
Smooth muscle
Surgical techniques
Uterus
title In-Bag Morcellation as a Routine for Laparoscopic Hysterectomy
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