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Chapter-10 In Bag Morcellation of Fibroid and Large Uterus: A New Solution and Innovation to Tackle the Issue

BOOK TITLE: ISARCON 2017 Manual of Operative Hysteroscopy

Author
1. Trivedi Prakash
2. Patil Sandeep
3. Trivedi Soumil
ISBN
9789352700752
DOI
10.5005/jp/books/14175_11
Edition
1/e
Publishing Year
2018
Pages
10
Author Affiliations
1. Jaslok Hospital and Research Centre, Mumbai, National Institute of Laser, and Endoscopic, Surgery (NILES), Mumbai, Scientific Director, Aakar IVF-ICSI Centre, Mumbai, Dr Trivedi’s Total Health Care Centre, Mumbai, Dept. Rajawadi Municipal Hospital and Shri DY Patil Medical College, Mumbai, Rajawadi Hospital, Mumbai, National Institute of Laser and Endoscopic Surgery (NILES), Mumbai, Jaslok Hospital and Research Centre, Mumbai; Aakar IVF – ICSI Centre, Mumbai; Hon.Asst.Prof. Pd. D.Y.Patil Medical College and V.C.Gandhi-Rajawadi Municipal Hospital, National Institute of Laser and Endoscopic Surgery NILES – Mumbai, Jaslok, Wockhardt and BARC Hospital, Mumbai, India, NILES and Aakar IVF~ICSI Centre, Dr Trivedi’s Total Woman’s Health Care Centre, Mumbai, Maharashtra, India, National Institute of Laser and Endoscopic Surgery (NILES), Mumbai, Jaslok Hospital and Research Centre, Mumbai, India, National Institute of Endoscopic Surgery and Laser Foundation, Jaslok Hospital and Research Centre, Mumbai, VC Gan
2. Yashadaa Hospital, Mumbai, Maharashtra, India
3. Dr Trivedi’s Total Health Care Centre, Rajawadi Municipal Hospital, Mumbai, Maharashtra, India, Dr Trivedi’s Total Health Care Pvt Ltd and Aakar IVF Centre, Mumbai, Maharashtra, India, Dr Trivedi’s Total Health Care Centre; Rajawadi Municipal General Hospital, Mumbai, Maharashtra, India
Chapter keywords
Laparoscopic morcellation, fibroid, occult malignancy, fertility, abdominal cavity, morcellation bag, laparoscopic hysterectomy, morcellation process

Abstract

Electromechanical morcellation was first introduced to the market almost 20 years ago and has since enabled surgeons to offer patients a minimally invasive approach to hysterectomies and myomectomies. The benefits of minimally invasive surgery are well known and include faster recovery, less pain, less blood loss, and lower risk of overall morbidity and mortality. However, laparoscopic morcellation has important drawbacks that include the risk of severe trauma, tissue disruption that makes pathologic diagnosis more difficult, and dispersion of the morcellated tissue throughout the abdominal cavity. The use of morcellation within specimen retrieval pouches for containment of benign or malignant uterine tissue requires significant skill and experience, and the use of specimen retrieval pouches should be investigated further for safety and outcomes in a controlled setting. A detailed discussion on the technique of laparoscopic myomectomy along with the technical issues of the procedure has been described in this chapter.

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