Contained Morcellation: Review of Current Methods and Future Directions

Abstract

Power morcellation of surgical specimen during laparoscopic surgery is a practical technology that provides the opportunity to perform several minimally invasive procedures. However, this technology brought forward additional risks and complications associated with dissemination of both benign and malignant tissues inside the abdominal cavity. Based on startling cases, Food and Drug Administration (FDA) announced a discouraging statement on the use of power morcellators that decreased the number of minimally invasive approaches in the following period. As a response to these concerns and negative impacts of the FDA statement, researchers developed several new approaches resulting in contained or in-bag morcellation methods. In this review, we aimed to discuss these current methods and provide an insight for future developments.

Iatrogenic parasitic myoma and iatrogenic adenomyoma after laparoscopic morcellation: A mini-review

“…Furthermore, the complexity of this technique may require more advanced training to ensure safety in the hands of novice users [58]. In the review titled “Contained Morcellation: Review of Current Methods and Future Directions”, the authors concluded that there is currently no available method for tissue extraction that completely eliminates the risk of cellular dissemination [59]. The FDA discouraged the use of laparoscopic power morcellation to avoid the spread and worsened clinical outcomes of unsuspected uterine malignancy with a first safety communication warning in April 2014 [60], [61].…”

Hawk® JAWS versus Lumenis® VersaCut prostate morcellation devices: A comparative study and comprehensive literature review

“…Morcellation can be defined as dividing a large tissue sample into smaller pieces to facilitate tissue extraction as a result of surgery (16). In the morcellation step, the last step of HoLEP, free prostate tissue pushed into the bladder following enucleation is taken out in small pieces.…”

Laparoscopic myomectomy: a review of alternatives, techniques and controversies

“…Minimally invasive surgery necessitates the safe extraction of wide surgical specimens through narrow laparoscopic ports. To overcome this challenge, ‘morcellation’, which has been described since the early 1990s (Box), involves the fragmentation of large tissue specimen(s) into smaller pieces to facilitate specimen extraction . Laparoscopic ‘power morcellators’ comprise a hollow cylinder terminating in a circular rotating blade.…”