In-Bag Morcellation as a Routine for Laparoscopic Hysterectomy

الملخص EN

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.