García-Gómez Borja, Gil-Moradillo Javier, Sola-Galarza Ignacio, Gimeno-Collado Alfonso, García-González Lucía, Campoy-Pérez Antonio Fidel, Andrés-Ramos Amparo, Rodríguez-Antolín Alfredo
Department of Urology, Salud Integral del Varón, Instituto de Investigación imas12, Hospital Universitario 12 de Octubre, Córdoba Avenue, 28041, Madrid, Spain.
Lyx Instituto de Urología, Universidad Francisco de Vitoria, Madrid, Spain.
Int Urol Nephrol. 2025 May 9. doi: 10.1007/s11255-025-04568-1.
To assess the efficiency and safety of the MultiCut Solo® morcellator in patients undergoing holmium laser enucleation of the prostate (HoLEP), and to analyze the influence of device settings, surgeon experience, and blade reuse on morcellation outcomes.
This prospective, multicenter, observational study included 232 patients undergoing HoLEP from January to September 2023 across two high-volume centers in Madrid, Spain. Three morcellation settings were evaluated: reduction, fast, and slow modes. Data on morcellation efficiency (g/min), surgeon experience (expert vs. trainee), and blade use frequency (0-10) were collected. Efficiency and complication rates were compared across groups. Statistical analysis was performed using Student's t-tests and Pearson's correlation.
A total of 326 morcellation instances were analyzed. Mean global morcellation efficiency was 14.5 g/min (SD ± 7.6), with reduction, fast, and slow modes yielding 16.7, 12.5, and 8.5 g/min, respectively. Surgeons' experience showed a non-significant trend toward higher efficiency (15.2 vs. 13.1 g/min, p = 0.051). Blade reuse up to 10 times did not significantly affect performance. Bladder perforation occurred in 1.29% of cases, and hematuria requiring temporary morcellation suspension in 3.88%. Obstruction occurred in 31.47% of cases, but disassembly was only required in 8.19%.
The MultiCut Solo® morcellator demonstrated high efficiency and a favorable safety profile. Efficiency was consistent across surgeon experience levels and was not significantly impacted by blade reuse within the manufacturer's recommended lifespan. These findings suggest that the device is effective and user-friendly, even in the early learning curve, and represents a valuable tool for tissue morcellation in HoLEP procedures.
评估MultiCut Solo® 组织粉碎器在接受钬激光前列腺剜除术（HoLEP）患者中的有效性和安全性，并分析设备设置、术者经验及刀片重复使用对组织粉碎结果的影响。
这项前瞻性、多中心观察性研究纳入了2023年1月至9月在西班牙马德里两个大型中心接受HoLEP手术的232例患者。评估了三种组织粉碎设置：缩小模式、快速模式和慢速模式。收集了关于组织粉碎效率（克/分钟）、术者经验（专家与实习生）以及刀片使用频率（0至10次）的数据。比较了各组的效率和并发症发生率。采用学生t检验和Pearson相关性进行统计分析。
共分析了326次组织粉碎实例。总体平均组织粉碎效率为14.5克/分钟（标准差±7.6），缩小模式、快速模式和慢速模式的效率分别为16.7克/分钟、12.5克/分钟和8.5克/分钟。术者经验显示出效率较高的非显著趋势（15.2克/分钟对13.1克/分钟，p = 0.051）。刀片重复使用多达10次对性能无显著影响。膀胱穿孔发生在1.29%的病例中，因血尿需要暂时停止组织粉碎的发生率为3.88%。梗阻发生在31.47%的病例中，但仅8.19%的病例需要拆解。
MultiCut Solo® 组织粉碎器显示出高效性和良好的安全性。效率在不同术者经验水平中保持一致，且在制造商推荐的使用寿命内，刀片重复使用对其无显著影响。这些发现表明，该设备即使在早期学习曲线阶段也是有效且用户友好的，是HoLEP手术中组织粉碎的宝贵工具。
