In-bag manual versus uncontained power morcellation for laparoscopic myomectomy: randomized controlled trial

Venturella, Roberta; Rocca, Morena; Lico, Daniela; Ferrera, N. La; Cirillo, Roberto; Gizzo, Salvatore; Morelli, Michele; Zupi, Errico; Zullo, Fulvio

doi:10.1016/j.fertnstert.2015.12.133

Cited by 45 publications

(20 citation statements)

References 22 publications

(35 reference statements)

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“…Venturella et al [12] reported similar operative times between the 2 techniques, although time needed for in-bag manual morcellation in our trial was significantly shorter when compared with their findings. Furthermore, our results show that surgical times were not influenced by patients' BMI, suggesting that inbag manual morcellation could be a feasible option even in overweight women.…”

Section: Discussionsupporting

confidence: 63%

Can In-Bag Manual Morcellation Represent an Alternative to Uncontained Power Morcellation in Laparoscopic Myomectomy? A Randomized Controlled Trial

Frascà¹,

Esposti²,

Arena³

et al. 2017

Gynecol Obstet Invest

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Aims: The study aimed to evaluate feasibility and safety of in-bag manual morcellation compared to uncontained power morcellation during laparoscopic myomectomy. Methods: A total of 72 women undergoing laparoscopic myomectomy were randomized into 2 treatment groups: 34 patients underwent in-bag manual morcellation (experimental group) and 38 were submitted to uncontained power morcellation (control group). The primary end point was the comparison of morcellation operative time (MOT). Total operative time (TOT), rate of intraoperative complication, and postoperative outcomes in the 2 groups were regarded as secondary outcomes. Results: Mean MOT and TOT were longer in the experimental group than in the control one (MOT: 9.47 ± 5.05 vs. 6.16 ± 7.73 min; p = 0.01; TOT: 113.24 ± 28.12 vs. 96.74 ± 33.51 min; p = 0.01). No intraoperative complications occurred in either group and no cases of bag disruption or laparotomic conversion were recorded. No significant difference in hemoglobin drop, hospital stay, and postoperative outcomes was reported between groups. Conclusion: In-bag manual morcellation appears a safe and feasible procedure and, despite slightly longer operative time, could represent an alternative to uncontained power morcellation.

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Section: Discussionsupporting

confidence: 63%

Can In-Bag Manual Morcellation Represent an Alternative to Uncontained Power Morcellation in Laparoscopic Myomectomy? A Randomized Controlled Trial

Frascà¹,

Esposti²,

Arena³

et al. 2017

Gynecol Obstet Invest

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“…Technical alternatives consist in vaginal, single-site, or manual open concepts for in-bag morcellation [22][23][24][25][26]. Vaginal access would have been possible for only one of our patients undergoing total hysterectomy, while it was not applicable for all others, operated upon supracervically.…”

Section: Discussionmentioning

confidence: 99%

In-Bag Morcellation as a Routine for Laparoscopic Hysterectomy

Rimbach

Schempershofe

2017

Journal of Minimally Invasive Gynecology

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“…Morcellator port site is meticulously closed by port closure needle. Contained bag morcellation, 15 posterior colpotomy, and laparoscopic-assisted myomectomy (LAM) are also used in selected cases. Instillation of Icodept 4% (Icodextrin) or lactate solution 2 L was done at the end of procedure for hydroflotation and to prevent adhesion formation.…”

Section: Methodsmentioning

confidence: 99%

Multiple-layer Closure of Myoma Bed in Laparoscopic Myomectomy

Singh¹

2013

International Journal of Gynecological Endoscopy

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Objective: To assess the feasibility and outcome of laparoscopic myomectomy and multiple-layer closure of myoma bed for management of myomas at a tertiary care hospital. Materials and methods:Five hundred and ten patients from January 2011 to January 2017 with large and moderate size myomas were managed by laparoscopic myomectomy. Indications were subfertility, menorrhagia, and abdominal mass. Preoperative evaluation included history, clinical examination, and sonographic mapping. Myomas were enucleated and retrieved laparoscopically. Myoma beds were sutured in multiple layers by endoscopic intracorporeal suturing. Fluid as adhesion barrier was used.Results: Three hundred and eighty two patients presented with subfertility, 69 with menorrhagia, and 59 with abdominal mass. The average maximum diameter of myoma was 9.1 cm. The mean duration of surgery was 90 minutes. The mean postoperative stay was 24 hours. No intraoperative complication occurred and the hospital course was uncomplicated. In seven cases, minilap incision was given for retrieval of myoma and suturing of the bed. Two patients had minor delayed wound healing of the morcellator port site. The patients did not report any complaints during follow-up except one patient who developed omental hernia at morcellator port site. There was no rupture of scar and very low adhesion scores in subsequent cesarean sections or second look scopies. Conclusion:With proper multilayer closure of the myoma bed, laparoscopic myomectomy is feasible for moderate and even large myomas and has good outcomes in terms of fertility and alleviation of symptoms.

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In-bag manual versus uncontained power morcellation for laparoscopic myomectomy: randomized controlled trial

Abstract: NCT02086435.

Cited by 45 publications

References 22 publications

Can In-Bag Manual Morcellation Represent an Alternative to Uncontained Power Morcellation in Laparoscopic Myomectomy? A Randomized Controlled Trial

Can In-Bag Manual Morcellation Represent an Alternative to Uncontained Power Morcellation in Laparoscopic Myomectomy? A Randomized Controlled Trial

In-Bag Morcellation as a Routine for Laparoscopic Hysterectomy

Multiple-layer Closure of Myoma Bed in Laparoscopic Myomectomy

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