Contained morcellation using the GelPOINT advance access platforms and 3M Steri-Drape endobag

Practice patterns and postoperative complications before and after US Food and Drug Administration safety communication on power morcellation

“…As novel methods of laparoscopic tissue removal develop, these changes in surgical practice may shift back toward laparoscopic surgery, and the current trends may not prove to be long-lasting. [12][13][14][15][16][17][18][19][20] The study found an association between the FDA morcellation safety communication and surgical morbidity for patients. We found a 27% increase in major, nonblood transfusion, postoperative complications following the FDA safety communication, as well as a 25% increase in hospital readmissions.…”

Power Morcellation Using a Contained Bag System

“…It is produced by various companies, with the most popular being the 3M Steri-Drape isolation bag (3M, St. Paul, Minnesota, USA). The Lahey bag was first used for the laparoscopic removal of large spleens in 2001, with a report revealing successful removal of 2 spleens: one 2510 g and the other 1720 g. 39 The LapSac Surgical Tissue Pouch (Cook Medical, Bloomington, Indiana, USA) is made of reinforced nylon with a polyurethane inner coating and the largest size is 8 × 10 inches with a volume of 1500 mL. The Anchor TRS-200 bag (Anchor Surgical, Addison, Illinois, USA) is made of ripstop nylon, has a volume of 3000 mL, and can hold specimen up to 1500 g. 26 The EndoCatch bag (Covidien, Medtronic, Mansfield, Massachusetts, USA) comes in either a 10- or 15-mm long cylindrical tube.…”

“…We have developed this technique in our practice, and it has been reported in the literature as well. 26,39 In the first technique, a single site platform, a morcellator with an extra-long cannula and an angled laparoscope are used. The downsides to this technique are instrument crowding and the need for a larger incision leading to potential increased postoperative pain, a slower return to normal activities, increased infection risk, and bleeding risk, as well as worse cosmesis.…”

Response: Another consideration in minilaparotomy for myomectomy

“…As clearly defined by the American Association of Gynecologic Laparoscopists (AAGL), the technique of tissue extraction using power morcellation needs to be optimized via research and educational programs, and power morcellation should be reserved for lowrisk patients after appropriate screening and informed consent (AAGL, 2014). At the moment, more and more publications are appearing in the literature about new surgical techniques and instruments for tissue removal (Kujansuu et al, 2015;Srouji et al, 2015) and it is likely that these techniques will become the gold standard for laparoscopic myomectomy in clinical practice in the near future. Moreover, the feasibility of these procedures needs to be confirmed in different settings and in larger populations.…”