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The Impact of Contained Versus Uncontained Morcellation Following Laparoscopic Myomectomy on Operation Time, Pain
Ann-Sophie Jensen1,2, Martin Rudnicki1,2
1Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark.
Title:
The impact of contained power versus uncontained manual morcellation following laparoscopic myomectomy on operation time, pain perception, and bleeding.
Purpose:
Knowledge of contained power morcellation in relation to operation time, bleeding, and in-hospital-stay is sparse. Our study aimed to investigate how contained power versus uncontained manual morcellation following laparoscopic myomectomy influenced operation time and bleeding.
Methods:
Women undergoing laparoscopic myomectomy at Odense University Hospital between September 2019 and September 2024 were included. Inclusion criteria were women ≥ 18 years undergoing a laparoscopic myomectomy. The size of the myomas, number of myomas, and demographics did not affect patient eligibility. Exclusion criteria were robot-assisted or open myomectomy, and malignancy.
Results:
In total, 116 women met inclusion criteria and underwent laparoscopic myomectomy. Of these, 74 (63.8%) underwent contained power morcellation and 42 (36.2%) uncontained manual morcellation. The operation time was 118.0 min (±54.07) in the contained group and 114.5 min (±32.53) in the uncontained manual group (p = 0.704). Perioperative bleeding was significantly lower in the contained power group versus the uncontained manual group (224.5 mL [±358.6] vs. 521.1 mL [±497.2], p = 0.0005). The length of hospitalization did not differ between contained power group and the uncontained manual group (0.57 days [±0.98] vs. 0.69 days [±0.68]; p = 0.473). One woman in the uncontained manual group had an intraabdominal abscess, and two women had intraabdominal bleeding, one in the uncontained manual group and one in the contained power group.
Conclusion:
Our study demonstrated that contained power morcellation following myomectomy did not increase the operation time. The contained power morcellation was associated with lower perioperative bleeding; however, this finding should be interpreted cautiously because of the retrospective study design and potential residual confounding.
