Morcellation Inside A Zipper Bag Pouch: An Efficient And Safe Way to Retrieve A Large,Solid Ovarian Mass Laparoscopically

Abstract

Introduction: Laparoscopic retrieval of an ovarian cyst should aim at an intact removal, with minimal or no content spillage into the peritoneal cavity. By using the bag-retrieval technique, cystic ovarian masses can be collected, aspirated, and decompressed inside a closed system upon retrieval. However, laparoscopic retrieval of a solid ovarian mass is difficult and often has to be removed piece by piece, using an electric morcellator. It is not uncommon for specimen fragments to be spilled out into the abdomen during morcellation, requiring searching and individual removal afterward. Some of these fragments may still be left inside the abdominal cavity, and this will cause a major problem in cases of unexpected malignancy. Case Report: In this paper, the authors describe a new approach to prevent specimen spillage during laparoscopic removal of a large, solid ovarian mass. By cutting one side of a zipper bag, a pouch was created to shield off and protect the pelvic organs as well as the bowels in the lower abdomen. By morcellating the solid ovarian tumor over this pouch, we can collect the spilled-out fragments to minimize the risk of contamination. Conclusions: Our technique is simple and inexpensive, easy to perform, and minimizes the risk of bag perforation during morcellation. (J GYNECOL SURG 23:31)