ABSTRACT

Risks of electromechanical morcellation are spreading undiagnosed cancer, diffuse leiomyomatosis, and visceral injury (1).

Food and Drug Administration (FDA) safety communication discouraged use of power morcellators for leiomyoma extraction after the case of disseminated leiomyosarcoma following a laparoscopic hysterectomy (2). Since FDA warning, laparoscopic contained (in bag) morcellation became very popular. But this can be challenging.

This video explains and demonstrates: 1. Laparoscopic port placement, 2.Step by step laparoscopic multiport contained morcellation after myomectomy (including what type of bag for what size of fibroid, how to insert 5mm trocar into the bag, how to use the morcellator, positions of surgeon and assistant during the morcellation),3. Tips and tricks on each step of contained morcellation 4. Very important tips during the morcellation 5.Video demonstrations of these steps.

It seems to be laparoscopic contained morcellation is going to be standard practice and evolve in the future. But it is important to be aware of challenges and the risks of this relatively new technique.