Systematic Review and Meta Analysis of Contained and Uncontained Morcellation in Hysterectomy and Myomectomy

Objective: Since the availability of new systems for contained morcellation, we sought out to analyze all high quality studies available regarding possible differences in contained and uncontained techniques for morcellation of fibroids and uteri.
Data Sources: We systematically searched PubMed, Cochrane Central, Scopus, ClinicalTrials.Gov, MEDLINE and Web of Science from September 2010 through the end of September 2020 for our search terms.
Methods of Study Selection: We included studies that specifically enrolled patients undergoing power morcellation myomectomy or power morcellation hysterectomy procedures. In our search, we had no restriction on age, country, or publication date.
Tabulation, Integration, and Results: We extracted data related to study design, baseline characteristics of patients, and perioperative outcomes such as total operative time, total blood loss, and duration of hospital stay. We found no substantial difference in total operative time between contained power morcellation and uncontained manual morcellation myomectomy (P=0.52) but contained power morcellation had longer total operative time than uncontained power morcellation for hysterectomy and myomectomy (135.50 vs. 93.33 minutes, (P=0.003)). Total blood loss was comparable for contained power morcellation versus uncontained manual morcellation myomectomy (P=0.32) and contained power morcellation versus uncontained power morcellation myomectomy or hysterectomy (P=0.91). Regarding hospital stay duration, contained power morcellation and uncontained manual morcellation myomectomy had comparable results (P=0.5).
Conclusion: Contained power morcellation seems to result in a longer operating time than uncontained power morcellation for both hysterectomy and myomectomy. No differences were found in comparisons of blood loss, operative time, or comparison to manual methods of morcellation.