title: Vaginal Uterine Morcellation Within a Specimen Containment System: A Study of Bag Integrity.
abstract: OBJECTIVE
  To evaluate the integrity of the endoscopic bag after transvaginal in-bag morcellation of uteri that need to be removed by vaginal morcellation during total laparoscopic hysterectomy (TLH).
  
  
  METHODS
  Prospective pilot study (Canadian Task Force classification II-2).
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Twelve patients with uteri that needed to be removed and who required vaginal morcellation underwent TLH from September 2014 to February 2015, without suspected or confirmed malignancy.
  
  
  METHODS
  After transvaginal in-bag morcellation of uteri at the end of TLH, careful visual inspection of the endoscopic pouch, using diluted methylene blue, was carried out, highlighting any minimal bag damage.
  
  
  RESULTS
  No gross rupture was encountered after morcellation; however, 4 minimal ruptures were recognized (33%) after filling up the bag with diluted methylene blue.
  
  
  CONCLUSIONS
  Minimal lesions of the bag may occur after transvaginal morcellation of uteri that need to be removed by vaginal morcellation; this may potentially affect the spread of cancer cells into the abdominal cavity.
authors.affiliation: Department of Biomedical Sciences for Health, University of Milan, Macedonio Melloni Hospital, Milan, Italy.
authors.forename: Eugenio
authors.initials: E
authors.lastname: Solima
authors.affiliation: Department of Biomedical Sciences for Health, University of Milan, Macedonio Melloni Hospital, Milan, Italy. Electronic address: giuseppe.scagnelli@gmail.com.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Scagnelli
authors.affiliation: Department of Biomedical Sciences for Health, University of Milan, Macedonio Melloni Hospital, Milan, Italy.
authors.forename: Veronica
authors.initials: V
authors.lastname: Austoni
authors.affiliation: Department of Biomedical Sciences for Health, University of Milan, Macedonio Melloni Hospital, Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Natale
authors.affiliation: Department of Biomedical Sciences for Health, University of Milan, Macedonio Melloni Hospital, Milan, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Bertulessi
authors.affiliation: Department of Biomedical Sciences for Health, University of Milan, Macedonio Melloni Hospital, Milan, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Busacca
authors.affiliation: Department of Biomedical Sciences for Health, University of Milan, Macedonio Melloni Hospital, Milan, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Vignali
mesh_terms: D003264:Containment of Biohazards / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D010535:Laparoscopy; D008875:Middle Aged; D000069577:Morcellation; D010865:Pilot Projects; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D013048:Specimen Handling; D014599:Uterus / Q000473:pathology* / Q000601:surgery; D014621:Vagina / Q000473:pathology* / Q000601:surgery
keywords: Endobag; Total laparoscopic hysterectomy; Vaginal morcellation