Manual tissue extraction: Approach to vaginal morcellation

Abstract

<h3>Video abstract summary</h3> Vaginal morcellation is a manual tissue extraction technique used to remove large specimens following robotic, laparoscopic, or vaginal hysterectomy. This procedure allows the surgeon to continue offering minimally invasive options to select patient populations and circumvents the need for laparotomy for specimen extraction. In recent years, there have been concerns regarding morcellation and the potential for inadvertent dissemination of malignant tissue. However, with appropriate patient selection and thorough pre-operative evaluation, the risks are low. The objective of this video is to present the technique and required equipment for performing vaginal morcellation following laparoscopic hysterectomy. The case is a 43-year-old G3P3 female with abnormal uterine bleeding due a multi-fibroid 14–16 week sized uterus, who underwent a total laparoscopic hysterectomy, bilateral salpingectomy, cystoscopy and vaginal morcellation. In this video, we demonstrate a safe and effective vaginal morcellation technique performed with bisection of the uterus, sequential wedge resections and myomectomy.