Application of morcellation through small umbilical incision in laparoscopic myomectomy

To investigate the effect of morcellation through small umbilical incision in laparoscopic myomectomy. A total of 67 patients who underwent laparoscopic myomectomy in the Second Affiliated Hospital of Soochow University from February 2018 to October 2019 were retrospectively analyzed. Fibroids were loaded into disposable laparoscopic collection bags and then retrieved through small umbilical incision. The operation of all 67 patients were successfully completed. There were no leakage of collection bags or fibroids fragments found in the peritoneal cavity and the puncture holes. There were no spindle cells or malignant cells found in the peritoneal lavage cytology before and after operation. There were 64 cases of uterine leiomyoma, 2 cases of cellular leiomyoma, and 1 case of leiomyoma with cystic degeneration in postoperative pathological diagnosis. The weight of fibroid was 110-420 (227±106) g; the operation time was 58-274 (107±45) min; the time for retrieving specimen was 8-27 (18.4±10.6) min; the time for suturing umbilical incision was 4-11 (7.8±4.6) min; the score of pain numeric rating scale (NRS) at 24 h, 48 h, 72 h after operation was 4-6 (4.5±1.2) points, 2-4 (2.7±1.1) points, and 1-2 (1.6±0.4) points, respectively; the Hollander wound evaluation score was 3-5 (4.6±0.5) points. The umbilical incisions looked and healed well after operation. Morcellation through small umbilical incision in laparoscopic myomectomy is a safe and practical method of specimen removal, which may help to reduce the dissemination of iatrogenic tumors.