A newly developed morcellator creates a new dimension in minimally invasive surgery.

摘要

We compared the efficiency and safety of a newly developed morcellator with a conventional device for minimally invasive supracervical hysterectomy. The prospective, randomized parallel-group study was set in a department of obstetrics and gynecology within an Academic Teaching Hospital. Patients included 48 women; 20 treated with an existing laparoscopic morcellator (Group 1); 28 treated with newly developed laparoscopic morcellator (Group 2). The weight-adjusted dissection time was reduced significantly by more than half with the new morcellator (p <.01). Significantly fewer (p <.05) and longer pieces of tissue were removed with the new morcellator. The median weight of morcellated tissue in Group 1 was 120 g (range 35-450 g), and the median operating time to remove the morcellated tissue was 10 minutes (range 2-45 minutes). The corresponding figures in Group 2 were 110 g (range 50-320 g) and 4 minutes (range 0.5-12 minutes). No bladder or intestinal lesions or other iatrogenic organ damage was seen with either morcellator. None of the patients in either group had postoperative complications. All interventions were completed as planned in both groups, and none of the procedures had to be converted to an open operation. Adequate tissue for histologic analysis was obtained from all patients. We concluded that the newly developed morcellator is a safe and effective instrument for laparoscopic supracervical hysterectomy, offering a much shorter operation time for the removal of morcellated tissue than a conventional device and a low risk of injury to surrounding organs and tissue.