title: Power Morcellation Using a Contained Bag System.
abstract: OBJECTIVE
  The well-known advantages of minimally invasive surgery make the approach well suited for hysterectomy and other gynecological procedures. The removal of specimens excised during surgery has been a challenge that has been answered by the use of power morcellation. With this study we sought to assess the feasibility of power morcellation within a specimen bag.
  
  
  METHODS
  This was a retrospective cohort study including patients from a private practice in suburban Chicago, Illinois, who underwent contained electromechanical power morcellation during a laparoscopic or robot-assisted hysterectomy or myomectomy from May 2014 through December 2015. Contained power morcellation was performed with the Espiner EcoSac 230 (Espiner Medical Ltd., North Somerset, United Kingdom) specimen bag. Descriptive statistics were performed for both categorical and continuous data.
  
  
  RESULTS
  Of the 187 procedures performed, 73.8% were myomectomies, and 26.2% were hysterectomies. The patients' mean age was 40 (range, 25-54) years and mean body mass index was 28.7 (range, 17.3-57.6). The average specimen weight was 300 g, with the largest weighing 2134 g. Estimated blood loss averaged 98.4 mL. The postoperative admission rate was 12.3%, most of which were due to nausea and urinary retention. Seventeen patients (9.1%) had postoperative complications, most of which were minor, and 4 (2.1%) were readmitted. There were no bag failures or complications that were due to the use of the specimen bag or to power morcellation.
  
  
  CONCLUSIONS
  Performing electromechanical power morcellation within the Espiner EcoSac 230 specimen bag was successfully performed in 187 patients with no bag-related complications. This method of contained power morcellation is feasible, reliable, and reproducible, even for a large specimen.
authors.affiliation: Department of Obstetrics and Gynecology.
authors.forename: Courtney
authors.initials: C
authors.lastname: Steller
authors.affiliation: Minimally Invasive Gynecology, Advocate Lutheran General Hospital, Park Ridge, Illinois, USA.
authors.forename: Aarathi
authors.initials: A
authors.lastname: Cholkeri-Singh
authors.affiliation: Department of Obstetrics and Gynecology.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Sasaki
authors.affiliation: Minimally Invasive Gynecology, Advocate Lutheran General Hospital, Park Ridge, Illinois, USA.
authors.forename: Charles E
authors.initials: CE
authors.lastname: Miller
mesh_terms: D000328:Adult; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000295:instrumentation / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D000069577:Morcellation / Q000295:instrumentation* / Q000379:methods; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods*; D063186:Uterine Myomectomy / Q000295:instrumentation / Q000379:methods*
keywords: Contained morcellation; Leiomyosarcoma; Morcellation; Uterine morcellation