Comparison of manual vaginal morcellation with laparoscopic power morcellation in specimen retrieval during laparoscopic myomectomy

• Muralikrishnan Nambiar,*  
• Athulya Sreenivas,  
• Jithin Surendran,  
• Anupama Suresh Y

Abstract

Most popular specimen retrieval techniques in laparoscopic myomectomy are manual vaginal morcellation and power morcellation. We This was a prospective study from October 2018 - Sep 2022. A total of 150 patients underwent laparoscopic myomectomy. Specimen extraction time was about 9.744 ±1.076 minutes in the vaginal morcellation group and 77.366 ±324.067 minutes in power morcellation group (p value 0.062). Cost of surgery in US dollars was 954.550± 2.272 USD in vaginal morcellation group and 1266.329± 215.246 USD in power morcellation group (p value < 0.001). About 0.013± 0.112 patients in vaginal morcellation group required of additional analgesia post operatively. This was required in about 0.171 ± 0.379 patients in power morcellation group (p value < 0.001). Patients who had vaginal morcellation were discharge ready at 128.625 ± 13.664 minutes . Where as this was 182.561± 30.381 minutes in power morcellation group (p value of < 0.001). About 0.013± 0.112 patients in the vaginal morcelaltion group had wound related adverse effects. About 0.171 ± 0.379 patients had such adverse effects in the power morcellation group (p value < 0.001). From our findings we conclude that Manual vaginal morcellartion is a much quicker, inexpensive and less painful alternative to power moecellation to extract specimens after laparoscoic myometomy. Manual vaginal morcellation also has less wound related complications with quicker post operative discharge readiness.

Keywords

laparoscopy, myomectomy, laparoacopic myomectomy, morcellation, power morcellation,vaginal morcellation