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Complete plastic lining of the abdominal cavity during laparoscopic electromechanical morcellation—a promising technique
AbstractThe risk of intraperitoneal fragment dissemination of uterine tissue, especially the dissemination of unexpected leiomyosarcoma during electromechanical morcellation, has been increasingly debated during the last year. An improved technique for contained morcellation of uterine tissue inside an insufflated plastic bag during laparoscopy is presented. Twenty-one consecutive containedmorcellations were carried out during the summer of 2014, at one institution. Five lapa-roscopic myomectomies and 16 hysterectomies were per-formed. Standard laparoscopic equipment was used and a
transparent plastic bag was introduced into the abdominal cavity through the umbilical incision mounted on two curved blunt metal probes, which facilitated the placement of the uterine tissue into the bag. Morcellationwas carried out inside the plastic bag through the opening in the umbilicus. All 21 morcellations during the study period were successfully per-formed. The median operative time was 105 min (range 45– 180 min) and applying plastic bag and trocar median 10 min (range 4–30 min). Median specimen weight was 560 g (range 80–1265 g). No complications occurred, and no unintended bag perforation was identified. The presented improved contained morcellation technique is feasible in laparoscopic hysterectomy and myomectomy. Larger studies will however be required before the general introduction of the method
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