Abdominal Approaches to Tissue Containment and Extraction in Minimally Invasive Gynecologic Surgery

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• 作者：Gaby N. Moawad ; MD ; ^{gmoawad@mfa.gwu.edu" class="auth_mail" title="E-mail the corresponding author} ; David Samuel ; MD ; Elias D. Abi Khalil ; MD
• 关键词：Laparoscopy ; Minimally invasive gynecologic surgery ; Morcellation ; Surgical tutorial ; Tissue containment ; Tissue extraction
• 刊名：Journal of Minimally Invasive Gynecology
• 出版年：2016
• 出版时间：November-December 2016
• 年：2016
• 卷：23
• 期：7
• 页码：1032
• 全文大小：558 K

文摘

To show different abdominal methods of tissue containment and specimen extraction techniques as an alternative to electromechanical morcellation (EMM).

Design

A stepwise surgical tutorial using a narrated video (Canadian Task Force classification III).

Setting

An academic tertiary care hospital.

Interventions

Minimally invasive gynecologic surgery requires the extraction of large tissue specimens through small incisions. EMM was largely used until recently when the Food and Drug Administration issued a statement on its safety. In this video, we present alternative techniques to EMM as well as different methods of tissue containment. Uteri specimens are contained using a 3M Steri-Drape isolation bag (3M Healthcare, Maplewood, MN) and, alternatively, the Alexis Containment Extraction System (Applied Medical, Rancho Santa Margarita, CA). The contained specimen is manually extracted through the 2.5-cm umbilical port incision using the paper roll technique described here.

Conclusion

These techniques for tissue containment and extraction provide an alternative to EMM. They allow the minimally invasive surgeon to contain and retrieve large specimens. When used appropriately, these techniques can decrease conversion rates to open abdominal surgery. They are easily reproducible with a minimal learning curve.