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. 2024 Oct;310(4):1857-1876.
doi: 10.1007/s00404-024-07676-y. Epub 2024 Aug 3.

Transvaginal morcellation within an enclosed bag in gynecological surgeries: a comprehensive systematic review and analysis of safety, efficacy, and outcomes

Omar Alomari #  1 , Muhammed Edib Mokresh #  2 , Emir Muvaffak  1 , Rahime Nurbanu Bakir  1 , Raghad Al Shomali  1 , Serkan Akis  3 , Sami Acar  4 , Murat Api  5
Affiliations

Transvaginal morcellation within an enclosed bag in gynecological surgeries: a comprehensive systematic review and analysis of safety, efficacy, and outcomes

Omar Alomari et al. Arch Gynecol Obstet. 2024 Oct.

Abstract

Purpose: This systematic review aims to comprehensively assess the safety and efficacy of transvaginal morcellation within an enclosed bag in gynecological surgeries, with a focus on its benefits, potential risks, and recommendations for its use.

Methods: We conducted a comprehensive search of Epistemonikos, Web of Science, Medline (PubMed), Scopus, and Cochrane databases for studies on transvaginal contained morcellation in adult patients undergoing gynecological surgeries. The review included 22 studies that met the inclusion criteria, encompassing diverse surgical procedures, patient profiles, and outcomes. These studies were thoroughly reviewed and analyzed to assess the safety and efficacy of the morcellation technique.

Results: Key findings from the selected studies indicate that transvaginal morcellation within an enclosed bag offers several advantages in gynecological surgeries, including reduced invasiveness, shorter operative times, and minimal blood loss when compared to conventional methods. The risk of tumor recurrence or dissemination appears to be low when appropriate precautions are taken, emphasizing the technique's safety, especially when performed by experienced surgical teams. While some studies reported complications, these were generally not directly associated with the morcellation technique.

Conclusion: Transvaginal morcellation within an enclosed bag demonstrates potential as a safe and effective option for gynecological surgeries. The technique offers the benefits of minimally invasive procedures, including reduced bleeding, shorter recovery times, and improved cosmetic outcomes. This review also highlights the need for standardization in study methodologies and reporting, as the heterogeneity in outcomes across the selected studies poses challenges in drawing definitive conclusions.

Keywords: Gynecological surgery; In-bag; Safety; Surgical complications; Transvaginal.

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Conflict of interest statement

The Authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
PRISMA 2020 flow diagram for new systematic reviews which included searches of databases and registers only
Fig. 2
Fig. 2
The results of the RoB2 (Risk of Bias 2) Cochrane tool assessment for the included randomized trial conducted across five key domains
See this image and copyright information in PMC

Comment in

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