Contained morcellation using the GelPOINT advance access platforms and 3M Steri Drape endobag

The step-by-step technique of contained internal power and external hand morcellation is demonstrated using simulation and cadaver training to optimize its application to the live patient.

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Original Video Article

Authors

Stephen Kujansuu, M.D., Bijan W. Salari, B.S., Michael Galloway, D.O., Austin Findley, M.D., Jerome L. Yaklic, M.D., Jason C. Massengill, M.D., Steven R. Lindheim, M.D.

Volume 103, Issue 5, Page e36

Abstract

Objective:

To report a technique that safely allows power and hand morcellation for laparoscopic hysterectomy and myomectomy specimens in a contained fashion in the event of unsuspected uterine sarcoma or leiomyosarcoma.

Design:

Video article introducing a method for enclosed tissue morcellation for laparoscopic specimens.

Setting:

Hospital of an academic-based practice.

Patient(s):

Two patients underwent laparoscopic hysterectomy: a 57-year-old G7 P5025 female for leiomyoma, anemia, and a history of CIN-3; and a 38-year-old G0P0 female with a 10-year history of pelvic pain and severe dysmenorrhea who failed medical therapy.

Intervention(s):

A technique using the GelPOINT Platform incision extender system and GelSeal Cap (GSP) Advanced Access Platform and a 50 cm × 50 cm 3M Steri-Drape endobag for enclosed intracorporeal and extracorporeal tissue morcellation of laparoscopic specimens.

Main Outcome Measure(s):

For training purposes, we used a pelvic simulator and cadaver to describe the step-by-step process and troubleshoot issues to optimize intra- and extracorporeal morcellation. This allowed for easier implementation on the live patient.

Result(s):

Simulation training and the cadaver model provided a learning platform for contained internal power and external hand morcellation, accelerating the learning curve in its application to the live patient.

Conclusion(s):

The GSP and 3M Steri-Drape endobag is an alternative for laparoscopic power or hand morcellation. Using simulation training helped transition this technique to the live patient, allowing for easy and safe removal of tissue specimens and minimizing the potential for tissue seeding and dissemination.

Read the full text at: http://www.fertstert.org/article/S0015-0282(15)00139-9/fulltext

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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