In-Bag Morcellation During Laparoscopic Hysterectomy
During laparoscopic supracervical hysterectomy (LASH), in-bag morcellation takes no more time than uncontained morcellation but avoids cell dissemination.
To compare the total time required for LASH plus laparoscopic in-bag morcellation (LASH+) with LASH using laparoscopic uncontained morcellation (LASH−), researchers retrospectively compared 107 LASH+ procedures done from 2016 to 2018 with 47 LASH− procedures are done from 2015 to 2017. Three experienced surgeons in the same department of minimally invasive gynecologic surgery performed all of the hysterectomies, which were indicated for dysmenorrhea or a bleeding disorder.
For each surgery, total surgical time, surgical outcome, blood loss, and complications were measured. The researchers then compared these outcome measures by type of morcellation used during LASH.
As a result, the researchers found no difference between the 2 types of morcellation with regard to blood loss, complications, and surgical results. They found no significant difference in total surgical time required for LASH by type of morcellation used. The researchers observed that, although LASH with in-bag morcellation takes more time for bag use and handling, this type of morcellation eliminates the need to carefully sample lost tissue fragments and lavage the peritoneal cavity after morcellation.
“LASH with in-bag morcellation is not related to additional surgical time when compared to LASH with uncontained morcellation,” they concluded.