Related Experiment Video
Updated: Apr 20, 2026
Introduction of Intracapsular Rotary-cut Procedures IRCP: A Modified Hysteromyomectomy Procedures Facilitating Fertility Preservation
Published on: January 17, 2019
Comparison of morcellator and culdotomy for extraction of uterine fibroids laparoscopically
Chin-Jung Wang1, Jiah Min Lee2, Hsing-Tse Yu1
1Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine, Kwei-Shan, Tao-Yuan, Taiwan.
Objective:
To define a rational guideline for the removal of uterine fibroids after laparoscopic myomectomy (LM) by culdotomy or morcellator in multiparae.
Study Design:
A total of 416 multiparae receiving LM were retrospectively studied between November 1997 and January 2014. Of these, 335 had fibroids removed by culdotomy and 81 by a laparoscopic 15mm electromechanical morcellator. Data on parity, number, size and weight of fibroids, operating time, specimen removal time, blood loss, postoperative stay, hospital charges and complications were recorded. The patients were analyzed in four subgroups stratified by main fibroid size and type of procedure.
Results:
There was no significant difference in body mass index, number of fibroids removed, blood loss, complications, and hospitalization duration between the groups. For fibroids below 10cm, the morcellator was significantly faster compared to culdotomy (10min versus 12min, p<0.001). For fibroids 10cm and above, there was no significant difference in time by culdotomy compared to morcellator (24min versus 20min, p=0.497). The electromechanical morcellator was significantly more expensive.
Conclusion:
Fibroid size of 10cm may be used as a guide for the route of fibroid removal; below 10cm the morcellator is faster but more expensive, for fibroids 10cm and above, culdotomy can be considered as it has a similar removal time to the morcellator in multiparae.
