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Objective: To evaluate morcellation time and its complications between in-bag and open power morcellation during laparoscopic myomectomy (LM). Design: Retrospective study Setting: Takanohara Central Hospital, Nara, Japan. Patient(s): This study subjects were comprised of 80 patients who underwent LM with power morcellation. The data were collected from 40 patients who underwent in-bag power morcellation of myomas between December 2015 and September 2016, and were compared with the data collected from 40 patients who underwent open power morcellation between February 2015 and August 2015. Intervention(s): Comparison of the outcomes of the morcellation time and its complications between in-bag and open power morcellation groups. Result(s): There were no significant differences in the mean myoma weight, intraoperative blood loss, and postoperative hospital stay between the two groups. The mean morcellation time of the in-bag power morcellation group was longer than that for the open power morcellation group (22 vs. 12 minutes; P=0.004). There were no severe intraoperative complications among the two groups. However, in one case the myoma specimen might have leaked out due to 5mm ligation hole of the bag, which was detached at a loose boundary at the time of pulling out the bag. Conclusion: The mean morcellation time of the in-bag power morcellation group was 10 minutes longer than the open power morcellation group. However, the method of in-bag power morcellation can be very useful in preventing parasitic myomas and in minimizing the risk of inadvertent malignant tissue dissemination.

In-bag power morcellation versus open power morcellation for laparoscopic myomectomy