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Organ entrapment and renal morcellation: permeability studies
D A Urban1, K Kerbl, E M McDougall
1Division of Urology, Washington University School of Medicine, St. Louis, Missouri.
The Journal of Urology
|December 1, 1993
Summary
This study evaluated LapSac permeability during laparoscopic surgery. Results indicate that LapSacs remain impermeable during tissue morcellation, ensuring surgical safety.
Area of Science:
- Urology
- Surgical Technology
Background:
- Laparoscopic surgery utilizes containment systems like LapSacs for tissue morcellation.
- Potential LapSac integrity issues during high-speed morcellation require investigation.
Purpose of the Study:
- To assess the integrity and permeability of LapSacs after laparoscopic nephrectomy and nephroureterectomy in a porcine model.
- To determine if LapSacs maintain impermeability during high-speed electrical tissue morcellation.
Main Methods:
- 24 LapSacs were collected post-procedure; 4 were found perforated upon water testing.
- 18 intact LapSacs were tested for permeability using bovine serum albumin, indigo carmine, and a mouse bladder tumor cell line.
- Permeability was assessed by analyzing dialysate concentrations over time.
Main Results:
- No significant dialysis of bovine serum albumin or indigo carmine was detected in the tested LapSacs.
- A single tumor cell was observed in one test, likely due to contamination rather than leakage.
- 16% of LapSacs showed minor perforations upon initial water testing.
Conclusions:
- LapSacs demonstrate impermeability during the morcellation process when used correctly.
- The findings support the safe use of LapSacs in laparoscopic procedures involving tissue morcellation.
- Proper handling and use are crucial for maintaining LapSac integrity.