Prospective analysis of the morcellation efficiency of a novel device (MultiCut®) for prostate laser enucleation

To assess the efficiency and safety of the MultiCut Solo® morcellator in patients undergoing holmium laser enucleation of the prostate (HoLEP), and to analyze the influence of device settings, surgeon experience, and blade reuse on morcellation outcomes.

This prospective, multicenter, observational study included 232 patients undergoing HoLEP from January to September 2023 across two high-volume centers in Madrid, Spain. Three morcellation settings were evaluated: reduction, fast, and slow modes. Data on morcellation efficiency (g/min), surgeon experience (expert vs. trainee), and blade use frequency (0-10) were collected. Efficiency and complication rates were compared across groups. Statistical analysis was performed using Student's t-tests and Pearson's correlation.

A total of 326 morcellation instances were analyzed. Mean global morcellation efficiency was 14.5 g/min (SD ± 7.6), with reduction, fast, and slow modes yielding 16.7, 12.5, and 8.5 g/min, respectively. Surgeons' experience showed a non-significant trend toward higher efficiency (15.2 vs. 13.1 g/min, p = 0.051). Blade reuse up to 10 times did not significantly affect performance. Bladder perforation occurred in 1.29% of cases, and hematuria requiring temporary morcellation suspension in 3.88%. Obstruction occurred in 31.47% of cases, but disassembly was only required in 8.19%.

The MultiCut Solo® morcellator demonstrated high efficiency and a favorable safety profile. Efficiency was consistent across surgeon experience levels and was not significantly impacted by blade reuse within the manufacturer's recommended lifespan. These findings suggest that the device is effective and user-friendly, even in the early learning curve, and represents a valuable tool for tissue morcellation in HoLEP procedures.