Obstetrician and Gynecologist, Advanced Gynaecological Minimal - Access Surgery, Dubai London Clinic and Speciality Hospital, Dubai, United Arab Emirates.
Clinic for Gynecology, Obstetrics and Gynecological Oncology at the Pius Hospital, University Hospital for Gynecology, Carl von Ossietzky University, Oldenburg, Germany.
Int J Surg. 2019 Feb;62:22-27. doi: 10.1016/j.ijsu.2018.12.013. Epub 2019 Jan 10.
To evaluate the feasibility of using contained endobags (Morsafe) in the retrieval of the specimen during laparoscopic surgeries in presumably benign myomatous pathology.
We conducted a retrospective single center case - control study on 239 patients, between 01.05.2014 and 31.12.2017 for uterine myomata, presumed to be benign. The analyzed parameters were the method for contained specimen retrieval, the time of bag manipulation, practicability of action and the perioperative complications rate. The present work has been reported in accordance with the STROCSS criteria and guidelines [1].
the main laparoscopic interventions were myomectomy (n = 148 cases) and LASH (laparoscopic supracervical hysterectomy) (n = 68 cases), LASH with bilateral salpingectomy (n = 7), LASH and bilateral adnexectomy (n = 3), LTH (laparoscopic total hysterectomy) (n = 3), LTH and bilateral adnexectomy (n = 1), radical LTH with lymphonodectomy (n = 2), LTH with bilateral salpingectomy (n = 1) and adenomyomectomy (n = 6). In 3 cases using contained closed bags, there was an evidence of malignancy in the pathological sections: leiomyosarcoma (n = 1) and endometrial carcinoma (n = 2). There were no adverse events and no intra - or postoperative bag - induced complications. Regarding the intraoperative duration, the time of bag introduction was about 7 min, and morcellation approximately 12 min.
in - bag morcellation through endobag (Morsafe) proved to be a safe laparoscopic method in retrieval of myomatous tissue, potentially reducing the risk of dissemination and thereby improving the patients' safety avoiding spreading of benign disease and malignancy, but preserving the benefits of minimally invasive surgery. The advantages concerned not only the operating time and costs, but also the safety aspects in case of malignancy. As the system can help to reduce risk of cell dissemination it could also reduce the risk in case of occult malignancy.
评估在疑似良性子宫肌瘤病理的腹腔镜手术中使用密闭式取物袋（Morsafe）回收标本的可行性。
我们对 2014 年 5 月 1 日至 2017 年 12 月 31 日期间因子宫肌瘤行腹腔镜手术的 239 例疑似良性患者进行了回顾性单中心病例对照研究。分析的参数包括标本密闭式回收方法、取物袋操作时间、操作实用性和围手术期并发症发生率。本研究按照 STROCSS 标准和指南[1]进行报告。
主要腹腔镜手术干预为子宫肌瘤切除术（n=148 例）和腹腔镜下子宫颈切除术（LASH）（n=68 例）、双侧输卵管切除术的 LASH（n=7 例）、双侧附件切除术的 LASH（n=3 例）、腹腔镜全子宫切除术（LTH）（n=3 例）、双侧附件切除术的 LTH（n=1 例）、伴有淋巴结切除术的根治性 LTH（n=2 例）、双侧输卵管切除术的 LTH（n=1 例）和子宫腺肌瘤切除术（n=6 例）。在 3 例使用密闭式封闭袋的病例中，病理切片显示存在恶性肿瘤：平滑肌肉瘤（n=1 例）和子宫内膜癌（n=2 例）。无不良事件发生，也无术中或术后因取物袋引起的并发症。关于手术时间，取物袋的引入时间约为 7 分钟，粉碎时间约为 12 分钟。
经取物袋（Morsafe）行袋内粉碎术被证明是一种安全的腹腔镜方法，可降低肿瘤组织播散的风险，从而提高患者的安全性，避免良性疾病和恶性肿瘤的播散，但保留了微创手术的优势。该方法不仅可以缩短手术时间和降低成本，还可以在发生恶性肿瘤时提高安全性。由于该系统有助于降低细胞播散的风险，因此也可以降低隐匿性恶性肿瘤的风险。
