Details

Autor(en) / Beteiligte

• Raimondo, Diego
• Raffone, Antonio
• Franceschini, Camilla
• Virgilio, Agnese
• Palermo, Roberto
• Borghese, Giulia
• Maletta, Manuela
• Borgia, Alessandra
• Neola, Daniele
• Travaglino, Antonio
• Lenzi, Jacopo
• Guida, Maurizio
• Seracchioli, Renato

Titel

Comparison of perioperative surgical outcomes between contained and free manual vaginal morcellation of large uteruses following total laparoscopic hysterectomy

Ist Teil von

• International journal of gynecology and obstetrics, 2024-03, Vol.164 (3), p.1167-1173

Ort / Verlag

United States

Erscheinungsjahr

2024

Quelle

Wiley-Blackwell Journals

Beschreibungen/Notizen

• Objective To compare contained and free manual vaginal morcellation of large uteruses after total laparoscopic hysterectomy (TLH) in women at low risk of uterine malignancy in terms of feasibility and safety. Methods A single‐center, observational, retrospective, cohort study was carried out including all patients undergoing TLH requiring manual vaginal morcellation for specimen extraction of large uteruses from January 2015 to August 2021 at the Division of Gynecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero‐Universitaria of Bologna, Bologna, Italy. Patients were divided into two groups according to the type of manual vaginal morcellation (contained or free), and compared in terms of demographic, clinical, and perioperative data. Results In all, 271 patients were included: 186 (68.6%) in the contained morcellation group and 85 (31.4%) in the free morcellation group. The mean operative time was significantly lower in the contained morcellation group compared with the free morcellation group (median [interquartile range] 130 [45] vs. 155 [60] min; P < 0.001). No significant difference was found in complications related to the morcellation step, overall, intraoperative and postoperative complications, estimated blood loss, length of hospital stays, uterine weight, and rate of occult malignancy between the two groups. Conclusion Contained vaginal manual morcellation of the uterus after total laparoscopic hysterectomy using a specimen retrieval bag appears to be a safe procedure with significantly lower operative time than free vaginal manual morcellation. SYNOPSIS Contained vaginal morcellation of the uterus after total laparoscopic hysterectomy seems to be a safe procedure associated with reduced operative times.