Power Morcellation with Contained Tissue Extraction – A Retrospective Chart Review

Abstract

Study Objective To evaluate the clinical performance of power morcellation (PM) with contained tissue extraction (CTE) (PneumoLiner, Advanced Surgical Concepts, Limited, Wicklow, Ireland) for presumed benign indications for minimally invasive gynecological surgery (MIGS). Design Multi-center, retrospective, IRB-approved chart review conducted by a version-controlled protocol. The primary endpoint was operative time and was measured from skin incision to skin closure. Secondary endpoints included complications related to the surgical procedure, morcellator, or tissue containment device; integrity of the tissue containment device following post-operative inspection; specimen histopathology; 30-day hospital readmission; and device deficiencies. Data were pooled and descriptive statistics were used for per-protocol analysis. Setting Three tertiary care institutions in the United States Patients or Participants 211 cases including females ≥ 18 years of age indicated for MIGS (robotic or laparoscopic) using PM and CTE were included in this study. Cases were excluded if patients were peri- or post-menopausal, had a known malignancy, were candidates for en bloc tissue removal, had undiagnosed uterine bleeding, had suspected allergies to polyurethane, or had abdominal wall thickness > 10cm. Interventions N/A Measurements and Main Results Mean age and body mass index was 41.2±6.7 years and 30.9±7.1 kg/m2 respectively. Common surgical indications included: uterine fibroids 70% (148), abnormal uterine bleeding 63% (133), and endometriosis 19% (40). Mean operative time was 82±36.7 minutes. Post-operative complications were reported in 2.4% (5) of patients, including umbilical port site (3) and urinary tract infections (2); all were related to the surgical procedure. Integrity of the tissue containment device was maintained in 100% (211) of cases. Histopathology confirmed malignancy in 0.5% (1) of patients. There were no hospital readmissions or device deficiencies. Conclusion Power morcellation with contained tissue extraction is feasible in patients with presumed benign indications for minimally invasive gynecologic surgery.