Novel Technique for Contained Power Morcellation through Umbilicus with Insufflated Bag.
In April 2014, the US Food and Drug Administration published a safety communication warning of the risk of an unsuspected uterine sarcoma being morcellated during a laparoscopic procedure and therefore advising against the use of power morcellation. These statements have encouraged the scientific community to look for new techniques that allows performing this procedure in a safer way, decreasing the risk of malignant dissemination thorough the abdominal cavity. We describe a new technique for power morcellation using a plastic bag through umbilicus using a latex glove and skin retractor as a single port device. This new procedure was performed in 4 women diagnosed with myomatous uterus. Median age was 40.5 years. No intraoperative complications, conversion to laparotomy or bag rupture occurred. Median surgical time was 195 min and median morcellation time was 48 min. Median in-hospital stay was 4.5 days. This new technique could be an acceptable and feasible alternative for specimen delivery during laparoscopic hysterectomy and myomectomy. However, it is still necessary to increase the number of procedures to assess its safety in case of uterine sarcoma. The video and supplemental contents demonstrate the safety and feasibility of the technique.
Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain.
Maria A
MA
Leal
Antonio
A
Piñera
Javier
J
De Santiago
Ignacio
I
Zapardiel
D000328:Adult; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000295:instrumentation / Q000379:methods / Q000592:standards*; D006801:Humans; D010535:Laparoscopy / Q000592:standards*; D007889:Leiomyoma / Q000601:surgery*; D000069577:Morcellation / Q000295:instrumentation / Q000379:methods / Q000592:standards*; D010043:Outcome and Process Assessment, Health Care; D014472:Umbilicus / Q000601:surgery; D014594:Uterine Neoplasms / Q000601:surgery*