Vaginal Morcellation Inside Protective Pouch: A Safe Strategy for Uterine Extration in Cases of Bulky Endometrial Cancers: Operative and Oncological Safety of the Method

Practice patterns and postoperative complications before and after US Food and Drug Administration safety communication on power morcellation

“…As novel methods of laparoscopic tissue removal develop, these changes in surgical practice may shift back toward laparoscopic surgery, and the current trends may not prove to be long-lasting. [12][13][14][15][16][17][18][19][20] The study found an association between the FDA morcellation safety communication and surgical morbidity for patients. We found a 27% increase in major, nonblood transfusion, postoperative complications following the FDA safety communication, as well as a 25% increase in hospital readmissions.…”

A new in-bag system to reduce the risk of tissue morcellation: development and experimental evaluation during laparoscopic hysterectomy

“…Several approaches have been described in gynecology to date using different ways of bag insertion, morcellation and tissue extraction. These include abdominal port site [44][45][46][47][48][49] or transvaginal [50] insertion of the bag, open abdominal (mini-laparotomic) [49] or vaginal in-bag morcellation [51][52][53][54][55], each manually under direct vision, and laparoscopic power morcellation within a pseudo-pneumoperitoneum in the bag inside the abdomen [44][45][46][47][48][49][50]. The latter technique provides the possibility of containing morcellation, when vaginal access is not suitable.…”

Laparoscopic specimen retrieval bags in gyn surgery: Expert guidance on selection

“…Lastly, even though removing a specimen within a containment system minimizes spillage and reports of in-bag cold-knife tissue extraction in women with histologically proven endometrial cancer have suggested that it is safe, laparoscopic bags have not been proven to prevent the dissemination of malignant tissue fragments. 16,17 Overall, the inherent risks of specimen extraction during minimally invasive surgery are far outweighed by the well-established advantages of laparoscopic surgery, which carries lower risks of surgical complications such as bleeding and infection, shorter hospital stay, and quicker recovery time compared to laparotomy. There is no doubt minimally invasive surgery offers many benefits.…”