Cell Spillage after Contained Electromechanical Morcellation Using a Specially Designed In-Bag System for Laparoscopic Myomectomy: Prospective Cohort Pilot Study.

Details

Serval ID
serval:BIB_A5D24E3015CE
Type
Article: article from journal or magazin.
Collection
Publications
Title
Cell Spillage after Contained Electromechanical Morcellation Using a Specially Designed In-Bag System for Laparoscopic Myomectomy: Prospective Cohort Pilot Study.
Journal
Journal of minimally invasive gynecology
Author(s)
Lambat Emery S., Pluchino N., Petignat P., Tille J.C., Pache J.C., Pinto J., Botsikas D., Dubuisson J.
ISSN
1553-4669 (Electronic)
ISSN-L
1553-4650
Publication state
Published
Issued date
2019
Peer-reviewed
Oui
Volume
26
Number
7
Pages
1351-1356
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Few reports have investigated the use of endoscopic retrieval bags in the context of laparoscopic myomectomy with electromechanical morcellation. We performed a leak test of a specially designed endoscopic bag system in women undergoing laparoscopic myomectomy with contained electromechanical morcellation.
Prospective study.
University hospital.
Thirty-one women undergoing laparoscopic myomectomy with contained electromechanical morcellation.
Electromechanical morcellation was introduced for large specimen extraction during laparoscopic procedures. Complications such as retained/disseminated parasitic tissue were documented.
Systematic peritoneal washings were performed at 3 specific times: at baseline, T1, once the peritoneal cavity was accessed laparoscopically; T2, when the myometrial incision was closed after myomectomy; and T3, after contained electromechanical morcellation. After retrieval of the endoscopic bag from the abdominal cavity, visual inspection and water test on the bag with NaCl infiltration were performed to detect leaks attributed to intraoperative perforations. A pathologist performed cytologic analyses on the 3 washings. The mean endoscopic bag procedure duration was 9 minutes. The use of a specially designed endoscopic bag system was found to be easy in 45% of cases, and no complications were reported. Cytologic washings were positive for smooth muscle cell detection in 8 cases (25.8%) at T2 and 3 cases (9.7%) at T3. All positive cases at T3 already had detectable smooth muscle cells at T2. After retrieval from the abdominal cavity, perforations on the optic access of the endoscopic bag were observed in 3 cases.
The results from this pilot study are encouraging. The use of a specially designed endoscopic bag system could be an adjuvant to reduce the risk of disseminating cells during myomectomy.
Keywords
Adult, Containment of Biohazards/instrumentation, Equipment Failure, Female, Humans, Laparoscopy/methods, Morcellation/instrumentation, Morcellation/methods, Peritoneal Cavity/pathology, Pilot Projects, Prospective Studies, Uterine Myomectomy/methods, Uterine Neoplasms/surgery, Electromechanical morcellation, Endoscopic bag, Laparoscopic myomectomy, Minimally invasive surgery
Pubmed
Web of science
Open Access
Yes
Create date
15/09/2023 12:24
Last modification date
27/09/2023 6:04
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