Cell Spillage after Contained Electromechanical Morcellation Using a Specially Designed In-Bag System for...

Area of Science:

• Gynecologic Surgery
• Minimally Invasive Procedures
• Surgical Oncology

Background:

• Laparoscopic myomectomy with electromechanical morcellation is used for large fibroid removal.
• Concerns exist regarding the potential dissemination of benign or malignant cells during morcellation.
• Endoscopic retrieval bags aim to contain tissue during extraction.

Purpose of the Study:

• To assess the efficacy and safety of a novel endoscopic bag system during laparoscopic myomectomy with contained electromechanical morcellation.
• To evaluate the potential for reducing cell dissemination using this containment system.

Main Methods:

• Prospective pilot study conducted at a university hospital.
• Thirty-one women undergoing laparoscopic myomectomy with contained electromechanical morcellation were included.
• Systematic peritoneal washings and post-retrieval bag inspection were performed.

Main Results:

• The endoscopic bag system was easy to use in 45% of cases, with no reported complications during use.
• Smooth muscle cells were detected in peritoneal washings in 25.8% of cases at T2 and 9.7% at T3.
• Perforations were observed in the endoscopic bag in 3 cases after retrieval.

Conclusions:

• The use of this endoscopic bag system appears promising as an adjunct to minimize cell dissemination during myomectomy.
• Further investigation is warranted to optimize the system and confirm its benefits in reducing surgical risks.