Impact of Morcellation on Operative Time during Benign Laparoscopic Hysterectomy

Abstract

Study Objective Estimate the impact of morcellation on operating room time during benign hysterectomy, while adjusting for other factors known to impact operative time. Design Retrospective cohort study. Setting Two medical centers in Boston, MA. Patients or Participants All patient undergoing laparoscopic or robotic hysterectomy for benign indications between November 2014 to December 2017. Interventions All patients underwent a hysterectomy by a laparoscopic or robotic, total or supracervical, approach and required morcellation for specimen removal. In all cases morcellation was manual and contained in a specimen bag. Laparoscopic hysterectomies with additional concomitant surgical procedures were excluded with the exception of salpingectomy, oophorectomy and cystoscopy. Data was collected with regards to patient demographics, surgical history, surgical indication, operative time, pathologic uterine weight and surgeon's annual hysterectomy volume. Measurements and Main Results A total of 959 patients met inclusion criteria. The mean operative time in the morcellation group was 146 ± 4 minutes vs. 109 ± 2 minutes in the group not requiring morcellation (p Conclusion Need for morcellation independently contributes to operative time when adjusting for other measures that can contribute to prolonged operating time. If intended, morcellation should be named in the operative procedure title to maximize efficiency of operative schedules.