Steller Courtney, Cholkeri-Singh Aarathi, Sasaki Kirsten, Miller Charles E
Department of Obstetrics and Gynecology.
Minimally Invasive Gynecology, Advocate Lutheran General Hospital, Park Ridge, Illinois, USA.
JSLS. 2017 Jan-Mar;21(1). doi: 10.4293/JSLS.2016.00095.
The well-known advantages of minimally invasive surgery make the approach well suited for hysterectomy and other gynecological procedures. The removal of specimens excised during surgery has been a challenge that has been answered by the use of power morcellation. With this study we sought to assess the feasibility of power morcellation within a specimen bag.
This was a retrospective cohort study including patients from a private practice in suburban Chicago, Illinois, who underwent contained electromechanical power morcellation during a laparoscopic or robot-assisted hysterectomy or myomectomy from May 2014 through December 2015. Contained power morcellation was performed with the Espiner EcoSac 230 (Espiner Medical Ltd., North Somerset, United Kingdom) specimen bag. Descriptive statistics were performed for both categorical and continuous data.
Of the 187 procedures performed, 73.8% were myomectomies, and 26.2% were hysterectomies. The patients' mean age was 40 (range, 25-54) years and mean body mass index was 28.7 (range, 17.3-57.6). The average specimen weight was 300 g, with the largest weighing 2134 g. Estimated blood loss averaged 98.4 mL. The postoperative admission rate was 12.3%, most of which were due to nausea and urinary retention. Seventeen patients (9.1%) had postoperative complications, most of which were minor, and 4 (2.1%) were readmitted. There were no bag failures or complications that were due to the use of the specimen bag or to power morcellation.
Performing electromechanical power morcellation within the Espiner EcoSac 230 specimen bag was successfully performed in 187 patients with no bag-related complications. This method of contained power morcellation is feasible, reliable, and reproducible, even for a large specimen.
微创手术的诸多优势使其非常适合子宫切除术及其他妇科手术。手术切除标本的取出一直是个难题，电动旋切术解决了这一问题。本研究旨在评估在标本袋内进行电动旋切术的可行性。
这是一项回顾性队列研究，纳入了2014年5月至2015年12月期间在伊利诺伊州芝加哥郊区一家私人诊所接受腹腔镜或机器人辅助子宫切除术或子宫肌瘤剔除术时进行封闭式电动旋切术的患者。使用Espiner EcoSac 230（英国北萨默塞特郡Espiner Medical Ltd.）标本袋进行封闭式电动旋切术。对分类数据和连续数据进行描述性统计。
在187例手术中，73.8%为子宫肌瘤剔除术，26.2%为子宫切除术。患者的平均年龄为40岁（范围25 - 54岁），平均体重指数为28.7（范围17.3 - 57.6）。标本平均重量为300克，最大重量为2134克。估计平均失血量为98.4毫升。术后住院率为12.3%，大部分原因是恶心和尿潴留。17例患者（9.1%）出现术后并发症，多数为轻微并发症，4例（2.1%）再次入院。未发生因使用标本袋或电动旋切术导致的袋子故障或并发症。
在187例患者中成功地在Espiner EcoSac 230标本袋内进行了电动旋切术，未出现与袋子相关的并发症。这种封闭式电动旋切术方法是可行、可靠且可重复的，即使对于大标本也是如此。
