Comparison of Laparoscopic Enclosed Electromechanical Morcellation and Vaginal Enclosed Scalpel Morcellation at Laparoscopic Myomectomy

Laparoscopic tissue removal is one of the most challenging parts for the laparoscopic surgery. For this reason, electromechanical morcellation has long been used to facilitate the tissue removal in gynecology. However, electromechanical morcellation has long been performed inside the abdomen without any containment. Therefore, this practice has recently undergone increased scrutiny because of important concerns related to tissue dissemination during intracorporeal power morcellation. Thus, the US Food and Drug Administration released a safety communication discouraging power morcellation in laparoscopic hysterectomy and myomectomy procedures in April 2014.

As a result of this serious concern, the enclosed laparoscopic power morcellation has been come into prominence in gynecological surgery. Besides the removal of the tissues through vagina with posterior colpotomy is considered an another solution for this critical problem.

In the literature the comparison for the two techniques for tissue removal is considerably scarce. Therefore researchers are aiming to prepare a trial to compare the laparoscopic enclosed electromechanical morcellation and tissue removal thorough vagina with posterior colpotomy according to removal time, postoperative pain and postoperative sexual function.

腹腔镜组织取出术（Laparoscopic tissue removal）是腹腔镜手术（laparoscopic surgery）中最具挑战性的环节之一。为此，电动组织粉碎术（electromechanical morcellation）长期以来被用于辅助妇科手术中的组织取出操作。然而，此前电动组织粉碎术长期在腹腔内无任何防护措施下开展。近年来，由于学界对体内电动粉碎术过程中组织播散存在重大安全顾虑，该操作方式受到了愈发严格的审查。2014年4月，美国食品药品监督管理局（US Food and Drug Administration）发布安全通告，不建议在腹腔镜子宫切除术（laparoscopic hysterectomy）与腹腔镜肌瘤切除术（laparoscopic myomectomy）中使用电动组织粉碎术。

出于这一重大安全顾虑，密闭式腹腔镜电动组织粉碎术在妇科手术中逐渐崭露头角。此外，经后穹窿切开术（posterior colpotomy）经阴道取出组织，也被视作解决该临床难题的另一可行方案。

目前，现有医学文献中关于这两种组织取出技术的对比研究相当匮乏。因此，研究人员计划开展一项对照试验，对比密闭式腹腔镜电动组织粉碎术与经后穹窿切开术经阴道组织取出术的手术取出时间、术后疼痛程度及术后性功能恢复情况。