Feasibility of myomatous tissue extraction in laparoscopic surgery by contained in – bag morcellation: A retrospective single arm study

Devassy, Rajesh; Cezar, Cristina; Krentel, Harald; Verhoeven, Hugo C.; Devassy, Rohan Rajesh; Wilde, Maya Sophie de; Wilde, Rudy Leon De

doi:10.1016/j.ijsu.2018.12.013

Cited by 25 publications

(27 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moreover, it is possible to perform the vaginal extraction of the specimen in a containment system, even without morcellation [ 22 ]. According to the case here described and to the larger in-bag morcellation study published by us until now [ 15 ], we observed effective and safe implementation of in-bag morcellation in all cases, irrespective of patient weight or specimen size. Neither the thinnest (44.0 Kg) nor the heaviest woman (127.6 Kg) presented complications during surgery or bag manipulation and it was possible to remove big surgical specimens up to 2805 g (mean 435.5 g) without technical problems.…”

Section: Discussionsupporting

confidence: 63%

“…Although some studies showed an increase in surgical time due to the morcellation within a containment system, this is only the case during the early learning curve [ 13 ]; improvement in necessary operation time with increasing volume of cases and experience with the contained morcellation, even when compared with different types of containment, was published [ 14 ]. Complications associated in long-term patient outcome from tissue spilling and dissemination are avoidable even if the containment system has an increased operating time in the beginning of the implementation in the surgical work [ 15 ]. In leiomyoma, being the second most common disease for surgery to be performed in women, the possibility of adhesions is high; therefore, the importance of concomitant adhesion prophylaxis is important in all myomectomies [ 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

To Laparoscopically Preserve Fertility in Intraabdominal Giant Myoma with Application of Contained In-Bag Morcellation: Mission Impossible?

Devassy

Roche

Juan

et al. 2022

JCM

Self Cite

View full text Add to dashboard Cite

A technical video was produced to demonstrate in step-by-step fashion a multiple contained myomectomy of a 20 × 30 cm giant myoma and seven additional fibroids found in the same patient, which required two different types of specimen retrieval bags for the electronic power morcellation. This complete surgical procedure included leiomyomata enucleation, contained in-bag electronic power morcellation, uterine reconstruction and the application of an adhesion prophylactic medical product.

show abstract

Section: Discussionsupporting

confidence: 63%

Section: Introductionmentioning

confidence: 99%

To Laparoscopically Preserve Fertility in Intraabdominal Giant Myoma with Application of Contained In-Bag Morcellation: Mission Impossible?

Devassy

Roche

Juan

et al. 2022

JCM

Self Cite

View full text Add to dashboard Cite

show abstract

“…35 Contained in-bag morcellation has proven to be a safe and feasible laparoscopic method, which potentially reduces the risk of dissemination in benign disease, and in cases of unsuspected malignancy, maximizes patients' safety while preserving the advantages of minimally invasive surgery. 36 However, with myomectomy, there is some tissue disruption that causes cell spread even in the absence of morcellation. 37 Therefore, the choice of treatment for a patient with leiomyoma and a history of cancer should be carefully determined.…”

Section: Discussionmentioning

confidence: 99%

“…The US Food and Drug Administration has issued a safety communication discouraging the use of laparoscopic power morcellation for removal of the uterus or uterine fibroids and approved the use of a morcellator bag to prevent the spread of cancerous tissue 35 . Contained in‐bag morcellation has proven to be a safe and feasible laparoscopic method, which potentially reduces the risk of dissemination in benign disease, and in cases of unsuspected malignancy, maximizes patients' safety while preserving the advantages of minimally invasive surgery 36 . However, with myomectomy, there is some tissue disruption that causes cell spread even in the absence of morcellation 37 .…”

Section: Discussionmentioning

confidence: 99%

Unexpected tumor‐to‐tumor metastasis of synovial sarcoma within leiomyoma: A case report and literature review

Sakai

Morinaga

Koshiba

et al. 2020

J of Obstet and Gynaecol

View full text Add to dashboard Cite

A tumor metastasis within another tumor is known as tumor-to-tumor metastasis (TTM). We report a 43-year-old woman who presented with hypermenorrhea and an abdominal mass. She had history of a soft tissue tumor on her left ankle at 38 years of age. Laboratory data showed slight elevation of CA125 and no other abnormal findings and magnetic resonance imaging revealed a circumscribed margin mass in the uterine fundus. We diagnosed the mass as benign leiomyoma and performed total laparoscopic hysterectomy. Postoperative pathological examination revealed TTM of synovial sarcoma within the uterine leiomyoma. A database search identified 29 cases of TTM within uterine leiomyoma. The donor tumor was mostly breast cancer (in 23 cases). To the best of our knowledge, this is the first report of a sarcoma TTM to a uterine leiomyoma. Despite the difficulty of preoperative diagnosis, TTM should be considered during the treatment approach for a patient with leiomyoma and a history of malignant tumors.

show abstract

“…is investigated as it may possibly prevent morcellation complications. Preclinical and clinical results are promising but validating prospective studies are needed in order for in-bag morcellation to be the subject of a consensus recommendation [26][27][28][29][30][31].…”

Section: Radiofrequency Devices: Harmonic Ace 7 -Ethiconmentioning

confidence: 99%

Laparoscopic total hysterectomy still not routinely chosen Operative description and available instruments

2019

View full text Add to dashboard Cite

Hysterectomy is the most common gynecological surgical intervention; therefore, there are many technical variations in different healthcare systems around the world. We aimed to review, step by step, the technique of laparoscopic hysterectomy as well as to present the available variety of surgical instruments impartially so that the operative team can decide in an informed manner the model and characteristics of the equipment used. The surgical technique is presented based on the experience of the authors, focusing mainly on intraoperative recommendation and suggestions. Advantages and disadvantages of the available instruments are also extensively detailed. Surgical positioning, as well as inserting the uterine manipulator are essential steps. The open technique is used to create pneumoperitoneum. The utero-ovarian ligament or the infundibulopelvic ligament is identified, coagulated and cut. The round ligament is incised, entering the space between the two layers of the broad ligament and advancing caudally in this space, which, if correctly identified, should be avascular. The uterine vessels located on the posterior sheet of the broad ligament are dissected and coagulated. The vaginal wall is sectioned with the help of the manipulator’s cap, making it easier to expose the insertion line of the vagina on the cervix. The uterus is removed through the vagina or through a trans-parietal incision. Thereafter, the vagina is sutured using separate Vicryl sutures. Between 2011 and 2016, laparoscopic hysterectomy had an increasing trend all over Europe. With a reported percentage of 3%, Romania ranks last in hysterectomies performed laparoscopically. The laparoscopic approach offers the advantages of minimal invasiveness: less pain, faster recovery and early social reintegration; therefore, this trend of improvement should become more accepted.

show abstract

Feasibility of myomatous tissue extraction in laparoscopic surgery by contained in – bag morcellation: A retrospective single arm study

Cited by 25 publications

References 33 publications

To Laparoscopically Preserve Fertility in Intraabdominal Giant Myoma with Application of Contained In-Bag Morcellation: Mission Impossible?

To Laparoscopically Preserve Fertility in Intraabdominal Giant Myoma with Application of Contained In-Bag Morcellation: Mission Impossible?

Unexpected tumor‐to‐tumor metastasis of synovial sarcoma within leiomyoma: A case report and literature review

Laparoscopic total hysterectomy still not routinely chosen Operative description and available instruments

Contact Info

Product

Resources

About