Open Power Morcellation Versus Contained Power Morcellation Within an Insufflated Isolation Bag: Comparison of Perioperative Outcomes

Maria V. Vargas, Sarah L. Cohen, Noga Fuchs-Weizman, Karen Wang, Elmira Manoucheri, Allison F. Vitonis, Jon I. Einarsson

Research output: Contribution to journalArticle

Abstract

Study Objective: To compare perioperative outcomes, particularly operative time, between uncontained and in-bag power morcellation of uterine tissue at the time of laparoscopic surgery. Design: Canadian Task Force classification II-3. Setting: Academic tertiary care hospitals. Patients: Women undergoing laparoscopic hysterectomy or myomectomy who required morcellation of uterine tissue for specimen extraction. Interventions: Outcomes among patients who had in-bag power morcellation were compared with outcomes among patients who had traditional power morcellation. The technique for in-bag morcellation entails placing the specimen into a large containment bag within the abdomen, insufflating the bag within the peritoneal cavity, and then using a power morcellator to remove the specimen from inside the bag. Measurements and Main Results: The cohort consisted of 85 consecutive patients who underwent surgery with morcellation of uterine tissue. Prospective data collected from 36 patients who underwent in-bag morcellation were compared with retrospective data collected from the immediately preceding 49 patients who had uncontained power morcellation. Baseline demographics were comparable between the 2 groups although women who underwent in-bag morcellation were on average older than the open morcellation group (mean age in years [standard deviation], 49.19 [1.12] vs 44.06 [8.93]; p = .01). The mean operating room time was longer in the in-bag morcellation group (mean time in minutes [standard deviation], 119.0 [55.91] vs 93.13 [44.90]; p = .02). The estimated blood loss, specimen weight, hospital length of stay, and perioperative complication rate did not vary between the 2 groups. Operative times did not vary significantly by surgeon. There were no cases of malignancy or isolation bag disruption. Conclusions: In-bag power morcellation, a tissue extraction technique developed to reduce the risk of tissue dissemination, results in perioperative outcomes comparable with the traditional laparoscopic approach. In this cohort, the mean operative time was prolonged by 26 minutes with in-bag morcellation but may potentially be reduced with further refinement of the technique.

Original languageEnglish (US)
Pages (from-to)433-438
Number of pages6
JournalJournal of Minimally Invasive Gynecology
Volume22
Issue number3
DOIs
StatePublished - Mar 1 2015
Externally publishedYes

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Operative Time
Morcellation
Uterine Myomectomy
Length of Stay
Peritoneal Cavity
Advisory Committees
Tertiary Healthcare
Operating Rooms
Hysterectomy
Tertiary Care Centers
Abdomen
Laparoscopy
Weight Loss
Age Groups
Demography
Neoplasms

Keywords

  • Hysterectomy
  • In-bag morcellation
  • Laparoscopy
  • Morcellation
  • Myomectomy
  • Tissue extraction

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Medicine(all)

Cite this

Open Power Morcellation Versus Contained Power Morcellation Within an Insufflated Isolation Bag : Comparison of Perioperative Outcomes. / Vargas, Maria V.; Cohen, Sarah L.; Fuchs-Weizman, Noga; Wang, Karen; Manoucheri, Elmira; Vitonis, Allison F.; Einarsson, Jon I.

In: Journal of Minimally Invasive Gynecology, Vol. 22, No. 3, 01.03.2015, p. 433-438.

Research output: Contribution to journalArticle

Vargas, Maria V. ; Cohen, Sarah L. ; Fuchs-Weizman, Noga ; Wang, Karen ; Manoucheri, Elmira ; Vitonis, Allison F. ; Einarsson, Jon I. / Open Power Morcellation Versus Contained Power Morcellation Within an Insufflated Isolation Bag : Comparison of Perioperative Outcomes. In: Journal of Minimally Invasive Gynecology. 2015 ; Vol. 22, No. 3. pp. 433-438.
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abstract = "Study Objective: To compare perioperative outcomes, particularly operative time, between uncontained and in-bag power morcellation of uterine tissue at the time of laparoscopic surgery. Design: Canadian Task Force classification II-3. Setting: Academic tertiary care hospitals. Patients: Women undergoing laparoscopic hysterectomy or myomectomy who required morcellation of uterine tissue for specimen extraction. Interventions: Outcomes among patients who had in-bag power morcellation were compared with outcomes among patients who had traditional power morcellation. The technique for in-bag morcellation entails placing the specimen into a large containment bag within the abdomen, insufflating the bag within the peritoneal cavity, and then using a power morcellator to remove the specimen from inside the bag. Measurements and Main Results: The cohort consisted of 85 consecutive patients who underwent surgery with morcellation of uterine tissue. Prospective data collected from 36 patients who underwent in-bag morcellation were compared with retrospective data collected from the immediately preceding 49 patients who had uncontained power morcellation. Baseline demographics were comparable between the 2 groups although women who underwent in-bag morcellation were on average older than the open morcellation group (mean age in years [standard deviation], 49.19 [1.12] vs 44.06 [8.93]; p = .01). The mean operating room time was longer in the in-bag morcellation group (mean time in minutes [standard deviation], 119.0 [55.91] vs 93.13 [44.90]; p = .02). The estimated blood loss, specimen weight, hospital length of stay, and perioperative complication rate did not vary between the 2 groups. Operative times did not vary significantly by surgeon. There were no cases of malignancy or isolation bag disruption. Conclusions: In-bag power morcellation, a tissue extraction technique developed to reduce the risk of tissue dissemination, results in perioperative outcomes comparable with the traditional laparoscopic approach. In this cohort, the mean operative time was prolonged by 26 minutes with in-bag morcellation but may potentially be reduced with further refinement of the technique.",
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AU - Wang, Karen

AU - Manoucheri, Elmira

AU - Vitonis, Allison F.

AU - Einarsson, Jon I.

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N2 - Study Objective: To compare perioperative outcomes, particularly operative time, between uncontained and in-bag power morcellation of uterine tissue at the time of laparoscopic surgery. Design: Canadian Task Force classification II-3. Setting: Academic tertiary care hospitals. Patients: Women undergoing laparoscopic hysterectomy or myomectomy who required morcellation of uterine tissue for specimen extraction. Interventions: Outcomes among patients who had in-bag power morcellation were compared with outcomes among patients who had traditional power morcellation. The technique for in-bag morcellation entails placing the specimen into a large containment bag within the abdomen, insufflating the bag within the peritoneal cavity, and then using a power morcellator to remove the specimen from inside the bag. Measurements and Main Results: The cohort consisted of 85 consecutive patients who underwent surgery with morcellation of uterine tissue. Prospective data collected from 36 patients who underwent in-bag morcellation were compared with retrospective data collected from the immediately preceding 49 patients who had uncontained power morcellation. Baseline demographics were comparable between the 2 groups although women who underwent in-bag morcellation were on average older than the open morcellation group (mean age in years [standard deviation], 49.19 [1.12] vs 44.06 [8.93]; p = .01). The mean operating room time was longer in the in-bag morcellation group (mean time in minutes [standard deviation], 119.0 [55.91] vs 93.13 [44.90]; p = .02). The estimated blood loss, specimen weight, hospital length of stay, and perioperative complication rate did not vary between the 2 groups. Operative times did not vary significantly by surgeon. There were no cases of malignancy or isolation bag disruption. Conclusions: In-bag power morcellation, a tissue extraction technique developed to reduce the risk of tissue dissemination, results in perioperative outcomes comparable with the traditional laparoscopic approach. In this cohort, the mean operative time was prolonged by 26 minutes with in-bag morcellation but may potentially be reduced with further refinement of the technique.

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