Laparoscopic splenectomy with the newly devised morcellator.
OBJECTIVE
One of the major hurdles to overcome in the development of laparoscopic surgery has been finding effective extraction techniques for the removal of large tissue masses. The electromechanical morcellator makes it easy to remove relatively large sections of tissue from the abdomen through the existing incisions. To determine the safety and efficacy of the new morcellator in laparoscopic splenectomy, our preliminary experiences using the morcellator were reviewed and retrospectively compared with the results in patients who previously underwent conventional extraction techniques.


METHODS
From February 1992 to March 1996, 31 patients underwent laparoscopic splenectomy. In the last eight patients, the new morcellator was used to remove the spleen, while in the remaining 23 patients, a laparoscopic splenectomy was performed using the conventional extraction techniques.


RESULTS
In the last eight patients who underwent laparoscopic splenectomy, the newly devised morcellator was successfully used without any complications. The spleen could be removed from the abdominal cavity in an average of 15.9 +/- 10.4 minutes using the morcellator, while the average was 45.7 +/- 15.4 minutes using conventional techniques. It was not necessary to extend the skin incision in patients with the morcellator, while, on the other hand, a 2-cm extension of the existing skin incision was always required to remove the spleen in the latter method.


CONCLUSIONS
The morcellator was found to be an effective device which can safely, efficiently and rapidly remove tissue masses. This procedure is therefore considered to be one feasible way to solve the age-old problem of intracorporeal morcellation.
Hashizume
M
M
Department of Surgery II, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Migo
S
S
Tsugawa
K
K
Tanoue
K
K
Ohta
M
M
Sugimachi
K
K
D004867:Equipment Design; D005260:Female; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000601:surgery; D012189:Retrospective Studies; D013156:Splenectomy / Q000295:instrumentation* / Q000379:methods; D013997:Time Factors