Advances in Morcellation Technology

In response to oncologic safety concerns, engineers have worked to develop new technology aimed at improving tumor containment during morcellation. Containment morcellation systems have been designed with various bag or trap-bag designs incorporated into the morcellator to help collect and withdraw specimens intact through the laparoscopic port without contamination risks. New true tissue removal systems have also emerged that physically extract intact tissue fragments rather than shredding them, such as the use of electrically powered morcellators with grasper functionality.

Another approach involves the use of hybrid laparoscopy and robotic surgery technology. The da Vinci surgical system allows for intact specimen retrieval through a single port site during procedures like hysterectomy or myomectomy which essentially eliminates any risk of potential Laparoscopic Power Morcellators contamination altogether. The robot’s advanced instruments enable the surgeon performing the operation to manipulate tissue and suture with high dexterity through small incisions from a console rather than direct-hand access through the body. While robotic systems carry a higher cost they may provide a safe alternative to morcellation in appropriate cases needing minimally invasive tumor removal where occult malignancy risks exist.

Patient Selection is Key

With advances in tissue containment and extraction methods, laparoscopic power morcellation can still be considered an acceptable option for appropriate patients when performed judiciously by experienced surgeons. Pre-operative patient evaluation and testing remain paramount to determine candidacy and cancer risk levels. For instance, women over the age of 50 with an enlarged uterus but no significant risk factors on imaging like ultrasound may still be reasonable candidates. Meanwhile, those with worrisome clinical findings, a complex mass, or inconclusive imaging warrant extra precaution like performing a laparoscopic biopsy prior to morcellating. In very high risk cases traditional open surgery eliminating morcellation risks altogether is preferred if oncologic principles are the priority.

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