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Laparoscopic In-Bag Morcellation Compared with Conventional Morcellation of Myomas and Uterus with Myomas.
J Obstet Gynaecol India. 2020 Feb; 70(1):69-77.JO

Abstract

Study Objective

To evaluate contained bag electromechanical morcellation for removal of myomas and uterus with myomas, laparoscopically (Study group B), and compare it with uncontained laparoscopic morcellation (Control group A) in patients with similar parameters done earlier.

Design

Retrospective Cohort Comparative Study (Canadian Task Force 2-1).

Setting

Advanced Gynaecologic MAS, university recognized tertiary centre, Mumbai, India.

Patients

720 women had laparoscopic removal of myomas or large uterus with myomas during a study period of 6 years (from 13 May 2012 to 14 August 2018) with contained bag electromechanical or conventional morcellation.

Interventions

Laparoscopic hysterectomy, laparoscopic myomectomy, conventional uncontained morcellation, contained in-bag morcellation.

Main Outcomes Measures

Laparoscopic contained in-bag morcellation was compared with conventional morcellation of myomas and uterus with large myomas during a study period of 6 years. Parameters assessed were operating time, time for insertion of bag, morcellation of tissues and removal of bag, blood loss, complications, conversion to open surgery and histopathologic findings of tissues. In Group A, in the first 3 years, 355 women underwent uncontained morcellation. Myoma size and weight varied from 5 cm to 26 cm and 200 g to 3740 g respectively. The myoma number ranged from 1 to 18. No case of leiomyosarcoma was reported. In Group B, in the next 3 years, 365 women underwent contained bag morcellation in 196 myomectomy cases and 169 hysterectomy cases. Myoma size and weight varied from 4 cm to 20 cm and 200 g to 2100 g respectively. The number of myomas varied from 1 to 17.

Results and Conclusion

Laparoscopic contained bag morcellation for myomas and uterus with large myomas were evaluated. In myomectomy group both conventional and in bag laparoscopic morcellation were comparable in terms of duration of the surgery and blood loss. When all cases ( hysterectomy and myomectomy combined together) and cases of hysterectomy with large fibroid were studied, laparoscopic in bag morcellation took less operative time and there was statistically significant difference in operative time . No case of leiomyosarcoma was found in our study of 720 cases of myomas or uterus with large myomas.

Authors+Show Affiliations

Aakar IVF-ICSI Centre, Dr. Trivedi's Total Health Care Pvt. Ltd., 1, 2, 3 Gautam Building, Tilak Road, Opp Balaji Temple, Ghatkopar East, Mumbai, 400077 India. Department of Obstetrics and Gynecology, Rajawadi Hospital, Mumbai, India.Aakar IVF-ICSI Centre, Dr. Trivedi's Total Health Care Pvt. Ltd., 1, 2, 3 Gautam Building, Tilak Road, Opp Balaji Temple, Ghatkopar East, Mumbai, 400077 India. Department of Obstetrics and Gynecology, Rajawadi Hospital, Mumbai, India.Yashadaa Hospital, Mumbai, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32030009

Citation

Trivedi, Prakash H., et al. "Laparoscopic In-Bag Morcellation Compared With Conventional Morcellation of Myomas and Uterus With Myomas." Journal of Obstetrics and Gynaecology of India, vol. 70, no. 1, 2020, pp. 69-77.
Trivedi PH, Trivedi S, Patil S. Laparoscopic In-Bag Morcellation Compared with Conventional Morcellation of Myomas and Uterus with Myomas. J Obstet Gynaecol India. 2020;70(1):69-77.
Trivedi, P. H., Trivedi, S., & Patil, S. (2020). Laparoscopic In-Bag Morcellation Compared with Conventional Morcellation of Myomas and Uterus with Myomas. Journal of Obstetrics and Gynaecology of India, 70(1), 69-77. https://doi.org/10.1007/s13224-019-01273-9
Trivedi PH, Trivedi S, Patil S. Laparoscopic In-Bag Morcellation Compared With Conventional Morcellation of Myomas and Uterus With Myomas. J Obstet Gynaecol India. 2020;70(1):69-77. PubMed PMID: 32030009.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laparoscopic In-Bag Morcellation Compared with Conventional Morcellation of Myomas and Uterus with Myomas. AU - Trivedi,Prakash H, AU - Trivedi,Soumil, AU - Patil,Sandeep, Y1 - 2019/12/09/ PY - 2018/12/25/received PY - 2019/09/03/accepted PY - 2021/02/01/pmc-release PY - 2020/2/8/entrez PY - 2020/2/8/pubmed PY - 2020/2/8/medline KW - Contained morcellation KW - Hysterectomy KW - In bag morcellation KW - Morcellation KW - Myoma KW - Myomectomy SP - 69 EP - 77 JF - Journal of obstetrics and gynaecology of India JO - J Obstet Gynaecol India VL - 70 IS - 1 N2 - Study Objective: To evaluate contained bag electromechanical morcellation for removal of myomas and uterus with myomas, laparoscopically (Study group B), and compare it with uncontained laparoscopic morcellation (Control group A) in patients with similar parameters done earlier. Design: Retrospective Cohort Comparative Study (Canadian Task Force 2-1). Setting: Advanced Gynaecologic MAS, university recognized tertiary centre, Mumbai, India. Patients: 720 women had laparoscopic removal of myomas or large uterus with myomas during a study period of 6 years (from 13 May 2012 to 14 August 2018) with contained bag electromechanical or conventional morcellation. Interventions: Laparoscopic hysterectomy, laparoscopic myomectomy, conventional uncontained morcellation, contained in-bag morcellation. Main Outcomes Measures: Laparoscopic contained in-bag morcellation was compared with conventional morcellation of myomas and uterus with large myomas during a study period of 6 years. Parameters assessed were operating time, time for insertion of bag, morcellation of tissues and removal of bag, blood loss, complications, conversion to open surgery and histopathologic findings of tissues. In Group A, in the first 3 years, 355 women underwent uncontained morcellation. Myoma size and weight varied from 5 cm to 26 cm and 200 g to 3740 g respectively. The myoma number ranged from 1 to 18. No case of leiomyosarcoma was reported. In Group B, in the next 3 years, 365 women underwent contained bag morcellation in 196 myomectomy cases and 169 hysterectomy cases. Myoma size and weight varied from 4 cm to 20 cm and 200 g to 2100 g respectively. The number of myomas varied from 1 to 17. Results and Conclusion: Laparoscopic contained bag morcellation for myomas and uterus with large myomas were evaluated. In myomectomy group both conventional and in bag laparoscopic morcellation were comparable in terms of duration of the surgery and blood loss. When all cases ( hysterectomy and myomectomy combined together) and cases of hysterectomy with large fibroid were studied, laparoscopic in bag morcellation took less operative time and there was statistically significant difference in operative time . No case of leiomyosarcoma was found in our study of 720 cases of myomas or uterus with large myomas. SN - 0971-9202 UR - https://www.unboundmedicine.com/medline/citation/32030009/Laparoscopic_In_Bag_Morcellation_Compared_with_Conventional_Morcellation_of_Myomas_and_Uterus_with_Myomas_ DB - PRIME DP - Unbound Medicine ER -
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