title: Comparison of methods of morcellation: manual versus power.
abstract: BACKGROUND
  With the growing controversy surrounding power morcellation (PM), other approaches must be examined so that women may still benefit from minimally invasive gynecologic surgeries. In this study we sought to compare power morcellation to manual morcellation through mini-laparotomy or vaginally.
  
  
  METHODS
  Retrospective cohort study carried out at an urban teaching hospital including 274 women who underwent a minimally invasive myomectomy or hysterectomy, requiring morcellation for tissue extraction. Surgical outcomes were compared between PM, manual morcellation through mini-laparotomy (MMM) and manual morcellation through the vagina (MMV). Primary outcome measured was operative time. Secondary outcomes were intraoperative and postoperative complications.
  
  
  RESULTS
  Compared with PM, MMM was associated with shorter operative time for hysterectomy, (140.5 min vs. 164.2 min, p = 0.05). Intraoperative and postoperative complications were similar among groups. There were four postoperative complications in the MMV group, one related to blood transfusion and three related to postoperative vaginal cuff and pelvic infections.
  
  
  CONCLUSIONS
  Compared with PM, MMM is associated with shorter operative time during hysterectomies. Intraoperative and postoperative complications were similar among groups.
authors.affiliation: Minimally Invasive Gynecologic Surgery, George Washington University, Washington, DC, USA.
authors.forename: Gaby N
authors.identifier: http://orcid.org/0000-0002-3240-1496
authors.initials: GN
authors.lastname: Moawad
authors.affiliation: Obstetrics & Gynecology Department, George Washington University, Washington, DC, USA.
authors.forename: Elias D
authors.identifier: http://orcid.org/0000-0003-3990-515X
authors.initials: ED
authors.lastname: Abi KhalIL
authors.affiliation: Minimally Invasive Gynecologic Surgery, George Washington University, Washington, DC, USA.
authors.forename: Jessica
authors.identifier: http://orcid.org/0000-0003-2252-1571
authors.initials: J
authors.lastname: Opoku-Anane
authors.affiliation: Minimally Invasive Gynecologic Surgery, George Washington University, Washington, DC, USA.
authors.forename: Cherie Q
authors.identifier: http://orcid.org/0000-0002-2158-723X
authors.initials: CQ
authors.lastname: Marfori
authors.affiliation: Obstetrics & Gynecology Department, George Washington University, Washington, DC, USA.
authors.forename: Alice C
authors.identifier: http://orcid.org/0000-0003-0997-6109
authors.initials: AC
authors.lastname: Harman
authors.affiliation: School of Medicine & Health Sciences, George Washington University, Washington, DC, USA.
authors.forename: Steven
authors.identifier: http://orcid.org/0000-0003-0745-0736
authors.initials: S
authors.lastname: Fisher
authors.affiliation: Epidemiology and Biostatistics Department, George Washington University, Washington, DC, USA.
authors.forename: Matt
authors.identifier: http://orcid.org/0000-0002-2164-1726
authors.initials: M
authors.lastname: Levy
authors.affiliation: Minimally Invasive Gynecologic Surgery, George Washington University, Washington, DC, USA.
authors.forename: James K
authors.identifier: http://orcid.org/0000-0002-1376-2202
authors.initials: JK
authors.lastname: Robinson
mesh_terms: D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000009:adverse effects / Q000379:methods*; D000069577:Morcellation / Q000009:adverse effects / Q000379:methods*; D061646:Operative Time; D012189:Retrospective Studies; D063186:Uterine Myomectomy / Q000009:adverse effects / Q000379:methods*
keywords: Electromechanical; manual; morcellation; power; vaginal