Obstet Gynecol Sci.  2018 Mar;61(2):267-273. 10.5468/ogs.2018.61.2.267.

In-bag power morcellation technique in single-port laparoscopic myomectomy

• Won YB
• Lee HJ
• Eoh KJ
• Chung YS
• Lee YJ
• Park SH
• Kim JW
• Lee JY
• Nam EJ
• Kim S
• Kim YT
• Kim SW

• KMID: 2420182
• DOI: http://doi.org/10.5468/ogs.2018.61.2.267

Abstract

OBJECTIVE
This study introduces and evaluates the feasibility, safety, and surgical outcomes of the in-bag power morcellation technique during single-port assisted (SPA) laparoscopic myomectomy in comparison with manual scalpel morcellation.
METHODS
This is a retrospective review of a total of 58 patients who underwent SPA laparoscopic myomectomy employing in-bag power morcellation (n=27) or manual scalpel morcellation (n=31), performed between December 2014 and December 2016. Surgical outcomes, including total operation time, estimated blood loss, postoperative hemoglobin changes, postoperative hospital stay, postoperative pain (visual analog scale), perioperative and postoperative complications were evaluated.
RESULTS
The demographics and patient characteristics were similar between both groups. The median patient age was 34 years and median body mass index was 20.84 kg/m2. The median specimen weight was 110 g. The median operating time was 138 minutes. The median estimated blood loss was 50 mL and the median postoperative hemoglobin change was 2.2 g/dL. The median postoperative hospital stay was 2 days and the median postoperative pain scores were 5 after 6 hours, 3 after 24 hours, and 2 after 48 hours. Occult malignancy was not identified in any patients. There were no intraoperative complications such as LapBag ruptures or gross spillage.
CONCLUSION
In-bag power morcellation for SPA laparoscopic myomectomy is feasible and safe, minimizing the risks of open power morcellation. There were also no statistically significant differences in surgical outcomes.

Keyword

Laparoscopy; Minimally invasive surgical procedures; Myomectomy; Morcellation

MeSH Terms

Body Mass Index
Demography
Humans
Intraoperative Complications
Laparoscopy
Length of Stay
Minimally Invasive Surgical Procedures
Morcellation*
Pain, Postoperative
Postoperative Complications
Postoperative Hemorrhage
Retrospective Studies
Rupture

Figure

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  Fig. 1 Simulation of 3XL LapBag insufflated with CO2 gas attached to single-port wound retractor.

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  Fig. 2 Intraoperative laparoscopic view of myoma power morcellation while contained within insufflated LapBag. (A) 3XL LapBag is opened intra-abdominally. (B) Myoma is inserted into the LapBag. (C) The myoma is grabbed with morcellator instrument. (D) The myoma is power morcellated within the insufflated LapBag.

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