Standardized comparison of prostate morcellators using a new ex-vivo model

Area of Science:

• Urology
• Surgical Technology

Background:

• Transurethral laser enucleation is common for benign prostate enlargement.
• Electric morcellators are used for tissue evacuation.
• A standardized method for evaluating morcellator settings is lacking.

Purpose of the Study:

• Develop an ex-vivo model for standardized morcellator evaluation.
• Identify optimal settings for different morcellators.
• Assess the efficacy of bovine heart as a prostate tissue simulant.

Main Methods:

• Prostate adenoma and various tissues (minced meat, sausage, bovine heart, pig fat, pig liver) were morcellated.
• Bovine heart was identified as the most equivalent tissue for testing.
• Four morcellators (Piranha, VersaCut, two prototypes) were tested at different speed settings in saline.

Main Results:

• Median retrieval rate for prostate adenoma was 14.02 g/min.
• Raw bovine heart retrieval rate was 13.75 g/min.
• Morcellator rates varied: Piranha (20 g/min), VersaCut (10.8 g/min), Karl Storz (9.8 g/min), Richard Wolf (38.6 g/min).

Conclusions:

• Raw bovine heart is a suitable ex-vivo simulant for prostate morcellator testing.
• Optimized oscillation speed and suction power enhance morcellation rates.
• Further clinical studies are needed to confirm these findings.