Risk of leakage with a new tissue containment system for power morcellation during gynecologic laparoscopy: An in vitro study

Abstract Purpose To evaluate leakage and tissue dissemination associated with a new tissue containment system for tissue removal during laparoscopic myomectomy morcellation using rigid pipes that can be seamlessly connected to detachable trocars. Methods Pork specimens were stained with indigo carmine dye and morcellated under laparoscopic guidance in a plastic trainer box. Morcellation was performed using two different containment systems. First, a polyurethane bag, 12 mm sheath for introduction into the peritoneal cavity, and 11 mm optic sleeve (control group). Second, a new tissue containment system using rigid pipes and detachable trocars (experimental group). All bags were inflated to 14–20 mmHg pressure using a standard CO2 insufflator. Visual evidence of spilled tissue or dye and procedure times were recorded. Results Thirty trials were performed using a multi-port approach and the two tissue containment systems. The leakage rate was 0.03% for the experimental group and 26.6% for the control group (p < 0.005). Morcellation time was significantly shorter in the experimental group compared to that in the control group (p < 0.05). Mean bag introduction and removal times of the experimental group were shorter than those of the control group; however, the removal time differences were not statistically significant. Conclusion The current study quantified leakage during morcellation and the convenience provided by a new tissue containment system. Further studies and clinical trials are needed to corroborate the findings and to evaluate the use of the new tissue containment system for minimally invasive surgical treatment of tumors.