Power morcellation in a specimen bag

Abstract

Study objective: To show a technique of power morcellation within a rip-stop nylon specimen bag.

Design: Step-by-step explanation of the technique.

Background: The Food and Drug Administration recently warned against the use of electromechanical power morcellation for hysterectomy and myomectomy because of potential tissue dissemination within the abdomen and pelvis. If the tumor is malignant, this technique increases the staging of the patient and may further warrant re-operation and chemotherapy. If the tumor is benign, the patient is at risk for parasitic myomas that may lead to, but are not limited to, pain and/or bowel obstruction.

Intervention: To reduce the preceding risks, we reviewed the techniques of power morcellation within a specimen bag used by other surgeons across the United States. This technique was modified to incorporate a more durable bag made out of rip-stop nylon. Laparoscopic supracervical hysterectomy during power morcellation was performed, along with an introduction to incorporating power morcellation of multiple myomas during a laparoscopic myomectomy.

Conclusion: This technique of power morcellation within a rip-stop nylon bag minimizes the risk of inadvertent tissue spread. This allows the patient an opportunity to undergo minimally invasive surgery for hysterectomy and myomectomy.

Keywords: Myoma; Myomectomy; Power morcellation; Specimen bag hysterectomy.