Laparoscopic renal ablation: An in vitro comparison of currently available electrical tissue morcellators

Jaime Landman, William C. Collyer, Ephrem Olweny, Cassio Andreoni, Elspeth McDougall, Ralph V. Clayman

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Objectives. Morcellation with the Cook high-speed electrical laparoscopic (HSEL) morcellator in an impermeable nylon/plastic sack (LapSac) has remained unchanged since its inception nearly one decade ago. Sack deployment and specimen entrapment remain relatively difficult, and morcellation with this device is expensive and relatively slow. As such, in an effort to facilitate specimen entrapment and morcellation, we adapted two currently available electrical morcellators (the Steiner gynecologic morcellator and the electrical prostate morcellator [EPM]) for renal morcellation and compared them with the HSEL morcellator. Methods. All morcellation was performed through a simulated abdominal wall under direct laparoscopic vision. Ten porcine kidneys were ablated with each of the following techniques: HSEL morcellation in a LapSac; HSEL morcellation in a fluid-filled LapSac; Steiner morcellation in an insufflated Endocatch sack; and EPM morcellation in a fluid-filled Endocatch sack. A modified laparoscopic trocar was constructed and used for the Steiner and EPM morcellation. The time to complete morcellation, morcellation product size, and entrapment sack integrity were evaluated for each technique. Cost data for each morcellator are also presented. Results. The mean morcellation time for the Steiner, HSEL dry, HSEL wet, and EPM morcellation was 6.0, 15.9, 14.7, and 26.0 minutes, respectively. The mean fragment size for these morcellators was 2.97, 0.65, 0.62, and 0.013 g, respectively. A single entrapment sack perforation was documented in a LapSac during routine HSEL morcellation. Conclusions. Renal morcellation with all three morcellators is feasible. The Steiner morcellator combined with an Endocatch resulted in more rapid morcellation and larger morcellation products. Copyright (C) 2000 Elsevier Science Inc.

Original languageEnglish (US)
Pages (from-to)677-681
Number of pages5
JournalUrology
Volume56
Issue number4
DOIs
StatePublished - Oct 2000
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Urology

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