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. 2020 Mar;12(3):237-243.
doi: 10.3892/mco.2020.1982. Epub 2020 Jan 21.

A comparative study on the short-term clinical efficacy of the modified laparoscopic uterine comminution technique and traditional methods

Xiaojun Shi  1 , Libing Shi  2 , Songying Zhang  2
Affiliations

A comparative study on the short-term clinical efficacy of the modified laparoscopic uterine comminution technique and traditional methods

Xiaojun Shi et al. Mol Clin Oncol. 2020 Mar.

Abstract

To assess the value of the modified laparoscopic uterine comminution technique in laparoscopic uterine surgery, a total of 82 cases of laparoscopic myomectomy were divided into the traditional group and modified group, according to a random number table. During the same period, 92 patients who underwent laparoscopic hysterectomy were divided into the conventional group and the modified group, according to a random number table. The patients in the conventional group and modified group who underwent laparoscopic uterine fibroid removal showed no significant differences in the operation time, blood loss or average hospitalization (P>0.05). There was no significant difference in the operative time or average length of hospital stay between patients in the conventional group and modified group who underwent laparoscopic hysterectomy (P>0.05). In laparoscopic myomectomy, the fibroid specimens were placed in a self-made specimen bag for modified uterine comminution. In laparoscopic hysterectomy, the whole uterus specimen was placed in a self-made specimen bag and viewed from the vagina. The improved comminution technique is simple and feasible, does not increase the operation time or length of hospitalization, and has value for clinical use.

Keywords: laparoscopic hysterectomy; laparoscopic myomectomy; modified laparoscopic uterine smashing technique.

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Figures

Figure 1.
Figure 1.
Laparoscopic sheath. (A) Scope of the 20x200 cm laparoscopic sheath. (B) Use one end with a white line as the head of the specimen bag. (C) Bottom of the specimen bag is knotted or tied with silk thread.
Figure 2.
Figure 2.
Crusher matching metal trocar. (A) Metal trocar with inflation port. (B) Metal trocar without inflation port.
Figure 3.
Figure 3.
Modified laparoscopic uterine comminution technique. (A) Inflatable port trocar directly connected to the gas tube. (B) Trocar without inflation port uses a Veress needle to connect the gas tube. (C) Laparoscopic specimen bag before inflation. (D) Laparoscopic specimen bag after inflation. (E) Grab the specimen directly in the specimen bag. (F) Grasping forceps hiden in the cutter head to grab the specimen. (G) Crushed the specimen in the specimen bag when the cutter head of the pulverizer was mostly hidden in the trocar. (H) Crushed the specimen in the specimen bag when the cutter head of the pulverizer was completely all hidden in the trocar.
Figure 4.
Figure 4.
Operation of specimen bag during hysterectomy. (A) Whole uterus specimen was taken from the vagina after being placed in the bag. (B) Specimen bag was taken out of the vagina and the specimen was smashed in the bag.
Figure 5.
Figure 5.
Position of the cutter head. (A) Cutter head was mostly hidden in the trocar. (B) Cutter head of the shredder was completely hidden inside the trocar.
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