Center for Minimally Invasive Gynecologic Surgery, Cedars-Sinai Medical Center, Los Angeles, California; and the Division of Minimally Invasive Gynecologic Surgery, Brigham and Women's Hospital, Boston, Massachusetts.
Obstet Gynecol. 2017 Dec;130(6):1251-1260. doi: 10.1097/AOG.0000000000002334.
Fragmented tissue extraction (morcellation) of uterine and leiomyoma tissue in gynecologic surgery has been performed for decades, but recent years have seen a vast expansion of techniques to address risks associated with tissue dispersion. Use of power, or electromechanical, morcellation has largely been replaced by manual morcellation with a scalpel. Morcellation can take place through a laparoscopic incision, a minilaparotomy incision, or through a colpotomy. Containment systems are now available for both power and manual morcellation, allowing tissue fragmentation to take place within an enclosed specimen bag. These products require additional training and skill and may add operating time, but have the potential to mitigate risks associated with tissue dissemination.
在妇科手术中，对子宫和子宫肌瘤组织进行碎片化组织提取（切碎）已经有几十年的历史了，但近年来，为解决与组织分散相关的风险，技术得到了广泛的扩展。电动或机电式切碎已基本被手术刀手动切碎所取代。切碎可以通过腹腔镜切口、小切口或阴道切开术进行。现在，电动和手动切碎都有容器系统，允许在封闭的标本袋内进行组织碎裂。这些产品需要额外的培训和技能，并且可能会增加手术时间，但有可能降低与组织传播相关的风险。
