Ex Vivo Comparison of Efficiency, Safety, and Surgeon Satisfaction in Four Commercial Morcellators

Date
2021
Language
American English
Embargo Lift Date
Committee Members
Degree
Degree Year
Department
Grantor
Journal Title
Journal ISSN
Volume Title
Found At
Mary Ann Liebert
Abstract

Introduction Holmium Laser Enucleation of the Prostate (HoLEP) is a size-independent treatment option for the management of benign prostatic hypertrophy. While advancements in laser technology have led to clinical improvements in the enucleation portion of HoLEP, the morcellation aspect of HoLEP is often the rate-limiting step. We sought to compare efficiency and surgeon satisfaction in four commercial morcellators. Methods This was an ex vivo study comparing four commercial morcellators: the Wolf Piranha, the Lumenis VersaCut, the JenaSurgical MultiCut Solo, and the Hawk Morcellator. Four surgeons with significant experience performing HoLEPs participated. Surgeons tested each device to morcellate two different prostate models 1) morcellating as much microwave-cooked chicken breast in 10 minutes and 2) timed morcellation of bull testicles. Surgeons completed subjective surveys after each morcellator trial. Objective outcomes included: morcellation efficiency (g/min morcellated) and aspiration power (time to aspirate 1 L of saline). Means of continuous variables were compared using ANOVA. Categorical variables were compared using chi-square tests. Statistical analyses were performed using SAS 9.4 (2019). Results Comparing subjective outcomes, the Piranha was chosen as the safest morcellator (p=0.0058). The least safe morcellator was thought to be the MultiCut by 75% of surgeons (p=0.046). The Piranha was chosen as the most effective morcellator by 75% of surgeons (p=0.046). Comparing objective parameters between the morcellators, the Piranha had the fastest aspiration time (43.50±10.34 s, p=0.0116). There were no significant differences in morcellation efficiency when using chicken breast (p=0.3096). However, when comparing the morcellation efficiency using bull testicles, the Piranha had the highest efficiency at 39.68±3.57 g/min (p=0.0268). Conclusion In this ex-vivo study comparing four different commercially available morcellators, the Piranha had the highest aspiration power. No significant differences were found in morcellation efficiency using microwave-cooked chicken breast. The Piranha was felt to be the safest and most effective morcellator.

Description
item.page.description.tableofcontents
item.page.relation.haspart
Cite As
Lee, M. S., Assmus, M. A., Cooley, L., Li, E., Large, T., & Krambeck, A. (2021). Ex Vivo Comparison of Efficiency, Safety, and Surgeon Satisfaction in Four Commercial Morcellators. Journal of Endourology. https://doi.org/10.1089/end.2021.0573
ISSN
0892-7790
Publisher
Series/Report
Sponsorship
Major
Extent
Identifier
Relation
Journal
Journal of Endourology
Rights
Publisher Policy
Source
Author
Alternative Title
Type
Article
Number
Volume
Conference Dates
Conference Host
Conference Location
Conference Name
Conference Panel
Conference Secretariat Location
Version
Author's manuscript
Full Text Available at
This item is under embargo {{howLong}}