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Manual morcellation compared to power morcellation during robotic myomectomy

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Abstract

Clinical practice has drastically changed following the 2014 U.S. Food and Drug Administration (FDA) warning statement regarding power morcellation during laparoscopic hysterectomy and myomectomy. Despite investigation into alternative tissue extraction techniques, there remain a paucity of data associated with contained manual morcellation techniques. The goal of this study was to investigate the associated perioperative outcomes of contained manual morcellation compared to power morcellation in women undergoing robotic myomectomy. Performing manual morcellation (n = 38) resulted in a 21-min decrease in mean operative time (105.4 ± 42.2 vs 126.1 ± 44.1 min, p = 0.02) compared to power morcellation (n = 62). Women were younger (33 vs 36 years, p = 0.03) in the manual morcellation group, with all other patient demographics being similar. Median specimen weight (82 vs 104 g, p = 0.13), number of fibroids removed (2 vs 1, p = 0.16), estimated blood loss (10 vs 50 mL, p = 0.25), and post-operative morphine equivalents administered (5.57 ± 4.57 vs 5.29 ± 4.39, p = 0.76) were similar. The same-day discharge rate was not significantly different between the groups (86 vs 90%, p = 0.74). Linear regression modeling identified specimen weight, number of fibroids removed, and use of power morcellation as significant contributors to surgical time. Contained manual morcellation during robotic myomectomy is associated with a significant decrease in surgical time when compared to power morcellation, with similar post-operative narcotic administration and length of stay.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Sisters of Charity Hospital, 2157 Main Street, Buffalo, NY, 14214, USA

    Derrick J. Sanderson, Dana Cleason & Ali Ghomi

  2. W.H. Thompson School of Business, Brescia University, Owensboro, KY, USA

    Rohnn Sanderson

  3. Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA

    Catherine Seaman

Authors
  1. Derrick J. Sanderson
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  2. Rohnn Sanderson
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  3. Dana Cleason
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  4. Catherine Seaman
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  5. Ali Ghomi
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Correspondence to Ali Ghomi.

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The authors Derrick J Sanderson, Rohnn Sanderson, Dana Cleason, Catherine Seaman, and Ali Ghomi declare that they have no conflicts of interest.

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Sanderson, D.J., Sanderson, R., Cleason, D. et al. Manual morcellation compared to power morcellation during robotic myomectomy. J Robotic Surg 13, 209–214 (2019). https://doi.org/10.1007/s11701-018-0837-y

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  • DOI: https://doi.org/10.1007/s11701-018-0837-y

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