Category: BPH/LUTS: Electrosurgery, Lasers & Other Technology
Introduction & Objective :
To classify the performance of a new morcellator model (Multicut, Jena Surgical GmbH, Germany) (JS) we prospectively compared it with the current reference (Piranha, Richard Wolf GmbH, Germany) (PRW) in daily clinical use.
From Jan. - Dec. 2017 the morcellation data of 76 operations (36 PRW, 41 JS) were prospectively recorded.
For the JS, the pump, electronics, control screen and foot switch are integrated in a 140W Ho-laser. The hand piece can be plugged in there. The blades are only available for multiple use. In this study they were disposed after 5 uses.
The PRW is a „stand alone“ device. Due to their better performance, the disposable blades were used.
The suction of the PRW works indirectly via a water container, the JS has a direct outflow. The tissue collector is identical.
The following data were recorded: Weight of the morcellated tissue, morcellation time, morcellation speed (calculated), consumption of irrigation fluid, loss of pieces during morcellation, obstruction with necessity to change tools.
For Results also see Table 1.
In case of an obstruction with morcellated tissue, the systems presented with a fundamental difference: The JS always obstructed inside the (multiple use) blade. After replacement with a new one, the morcellation was continued immediately. The PRW always obstructed inside the motor handle. For that reason we always have a sterile replacement handle ready in the OR.
There were no bladder injuries or other complications in both series.
With a 15-35% higher morcellation speed, 20-30% less fluid consumption and a negligible number of piece losses compared to the Piranha, the results with the new morcellator are promising. Nevertheless, this should again be confirmed in a prospective randomized study.
Urology, Sana Klinikum Hof, Germany
Hof, Bayern, Germany
Dr. med. Sven Piesche
Section Head Endourology and Laser-Surgery
Dep. of Urology, Sana Klinikum Hof, Germany