title: Contained Morcellation for Laparoscopic Myomectomy Within a Specially Designed Bag.
abstract: A technique of contained morcellation of uterine myomas within a bag specially designed for 2-port morcellation during laparoscopic myomectomy is described. Ten patients underwent in-bag morcellation of myomas with a tissue isolation bag (MorSafe) between November 2014 and January 2015. The MorSafe tissue isolation bag is a retort-shaped bag made of medical-grade flexible plastic material with the wider opening of 134 mm in diameter and the tail end measuring 4 mm in diameter, allowing easy accomodation of specimens up to 12 cm in diameter. This technique involves placing the myomas into the isolation bag within the abdomen, exteriorizing the tail end of the bag, insufflating the bag within the peritoneal cavity, and morcellating the myomas under vision. Demographic and perioperative characteristics were studied. The mean operative time was 117 minutes (range, 75-195 minutes), the mean time for specimen introduction into the bag was 12.5 minutes (range, 7-22 minutes), and the mean time for morcellation and bag removal was 24.8 minutes (range, 10-50 minutes). There were no complications related to the in-bag morcellation technique, and there was no visual evidence of damage to the isolation bag. In-bag morcellation using this new bag is a feasible technique for morcellating uterine myomas in a contained manner and may provide an option to minimize the risks of open power morcellation while preserving the benefits of minimally invasive surgery.
authors.affiliation: Centre for Advanced Endoscopy and Infertility Treatment, Paul's Hospital, Cochin, Kerala, India. Electronic address: drpaulpg@gmail.com.
authors.forename: P G
authors.initials: PG
authors.lastname: Paul
authors.affiliation: Centre for Advanced Endoscopy and Infertility Treatment, Paul's Hospital, Cochin, Kerala, India.
authors.forename: Manju
authors.initials: M
authors.lastname: Thomas
authors.affiliation: Centre for Advanced Endoscopy and Infertility Treatment, Paul's Hospital, Cochin, Kerala, India.
authors.forename: Tanuka
authors.initials: T
authors.lastname: Das
authors.affiliation: Centre for Advanced Endoscopy and Infertility Treatment, Paul's Hospital, Cochin, Kerala, India.
authors.forename: Saurabh
authors.initials: S
authors.lastname: Patil
authors.affiliation: Centre for Advanced Endoscopy and Infertility Treatment, Paul's Hospital, Cochin, Kerala, India.
authors.forename: Reena
authors.initials: R
authors.lastname: Garg
mesh_terms: D000328:Adult; D003264:Containment of Biohazards / Q000295:instrumentation*; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007327:Insufflation; D010535:Laparoscopy / Q000379:methods; D007889:Leiomyoma / Q000473:pathology* / Q000601:surgery; D000069577:Morcellation; D009366:Neoplasm Seeding; D010529:Peritoneal Cavity / Q000473:pathology* / Q000601:surgery; D013048:Specimen Handling / Q000295:instrumentation*; D063186:Uterine Myomectomy / Q000379:methods*; D014594:Uterine Neoplasms / Q000473:pathology / Q000601:surgery*; D014599:Uterus / Q000473:pathology; D014621:Vagina / Q000473:pathology
keywords: Bag; Contained morcellation; Laparoscopic myomectomy