Aimee Daccache | Ecole Polytechnique Federale de Lausanne (original) (raw)

Papers by Aimee Daccache

Nature medicine, Apr 11, 2024

Children with rare, relapsed or refractory cancers often face limited treatment options, and few ... more Children with rare, relapsed or refractory cancers often face limited treatment options, and few predictive biomarkers are available that can enable personalized treatment recommendations. The implementation of functional precision medicine (FPM), which combines genomic profiling with drug sensitivity testing (DST) of patient-derived tumor cells, has potential to identify treatment options when standard-of-care is exhausted. The goal of this prospective observational study was to generate FPM data for pediatric patients with relapsed or refractory cancer. The primary objective was to determine the feasibility of returning FPM-based treatment recommendations in real time to the FPM tumor board (FPMTB) within a clinically actionable timeframe (<4 weeks). The secondary objective was to assess clinical outcomes from patients enrolled in the study. Twenty-five patients with relapsed or refractory solid and hematological cancers were enrolled; 21 patients underwent DST and 20 also completed genomic profiling. Median turnaround times for DST and genomics were within 10 days and 27 days, respectively. T re at ment r ec om me nd ations were made for 19 patients (76%), of whom 14 received therapeutic interventions. Six patients received subsequent FPM-guided treatments. Among these patients, five (83%) experienced a greater than 1.3-fold improvement in progression-free survival associated with their FPM-guided therapy relative to their previous therapy, and demonstrated a significant increase in progression-free survival and objective response rate compared t o t h o se o f e i g ht n on-g ui ded patients. The findings from our proof-of-principle study illustrate the potential for FPM to positively impact clinical care for pediatric and adolescent patients with relapsed or refractory cancers and warrant further validation in large prospective studies. ClinicalTrials.gov registration: NCT03860376. Cancer is the leading cause of disease-related death for children and teenagers in the United States. Despite improvements in survival for patients with cancers like acute lymphoblastic leukemia, progress for other high-risk, relapsed or refractory pediatric cancers remains challenging 1. These patients typically have few established treatment options, in spite of advancements in standard therapy 2,3. Genomics-guided precision oncology 4 aims to provide pediatric and adolescent patients with matched treatments based on molecular

Critical Care Medicine, Dec 13, 2023

Kansas journal of medicine, Nov 29, 2023

Cureus, Dec 28, 2023

Isolated testicular involvement in pediatric lymphoma is rare and poses diagnostic challenges. In... more Isolated testicular involvement in pediatric lymphoma is rare and poses diagnostic challenges. In this study, the case of an isolated testicular B-lymphoblastic lymphoma in a 9-year-old boy is discussed with an emphasis on the difficulties in diagnosing and treating such an unusual presentation. This example illustrates the importance of considering lymphoblastic lymphoma in the differential diagnosis of an unidentified source of testicular enlargement. Furthermore, it highlights the possible efficacy of systemic chemotherapy with or without surgical excision. The article advances our knowledge of this unusual clinical situation.

Kansas journal of medicine, Nov 28, 2022

Journal of Medical Case Reports, Sep 5, 2020

Background: Coughing is considered an important mechanism that helps the body get rid of foreign ... more Background: Coughing is considered an important mechanism that helps the body get rid of foreign substances or prevent their entry into the tracheobronchial tree. Infrequently, after the onset of coughing, patients presenting with persistent chest pain are found to have rib fractures. Among the cases reported for cough-induced rib fractures, the maximum number of fractured ribs was found to be four. Case presentation: In this report, we present a case of a healthy 50-year-old Lebanese smoker who developed a total of six fractures in five ribs, asymmetrically, after coughing for 2.5 months. Conclusion: This case report is, to our knowledge, the first to describe six cough-induced rib fractures in a smoker without an underlying predisposition.

Facts, views & vision in ObGyn, Jun 30, 2021

Autoamputation of the ovary is a rare occurrence of uncertain aetiology with only a few cases rep... more Autoamputation of the ovary is a rare occurrence of uncertain aetiology with only a few cases reported in literature. It usually develops following ovarian torsion or torsion of a dermoid cyst with subsequent necrosis of the pedicle and autoamputation. We present the case of a 42 year-old woman was admitted for a laparoscopic removal of a right ovarian cyst. The ultrasound showed a right ovarian cystic mass suggestive of a cystadenoma, and another heterogeneous small echogenic cyst of the left ovary. During laparoscopy, excessive bleeding from the ovarian cortex complicated the cyst stripping and, considering the age of the patient and the emerging technical difficulty of the procedure, a total adnexectomy for the right ovary was performed. While exploring the small cyst on the left ovary, a dermoid cyst was found in the Douglas pouch. This finding could be interpreted as an autoamputation of the adnexa due to an asymptomatic torsion of a previous ovarian cyst arising from the left ovary. Medical errors could occur due to lack of knowledge, expertise, as well as lack of training and surgical skills, but also due to an unfortunate association of very rare confounding factors. Even in the hands of experts, following the basic rules of surgery remains a milestone in teaching and preventing surgical complications.

International Journal of Clinical Research, Jun 4, 2022

Background: A unicornuate uterus with a rudimentary horn is a rare Mullerian anomaly with few cas... more Background: A unicornuate uterus with a rudimentary horn is a rare Mullerian anomaly with few cases reported in the literature. The symptoms vary depending on the functionality of the endometrial cavity and the presence of an obstruction. Adenomyosis is a disease defined as areas of endometrial glands and stroma present within the myometrium. Reports describing adenomyosis in relation to the Mullerian anomalies are scarce. Case Report: We present a 20-year-old middle eastern woman admitted for chronic pelvic pain and abdominal distension. Pelvic ultrasound revealed a unicornuate uterus with an adjacent mass of 10 x 8 cm. An MRI (Magnetic Resonance Imaging) was performed, and a left unicornuate uterus was demonstrated. On the right side, a large non-communicating rudimentary horn with features suggesting diffuse adenomyosis was found. Laparoscopic removal of the horn was performed successfully, and the extraction of the specimen was made by a power morcellation containment system. The patient was discharged uneventfully the second day after the surgery, and the pathology result confirmed the presence of diffuse adenomyosis. Conclusion: Non-communicating rudimentary horn is a rare finding manifesting as different symptoms in young women. The enlargement of the horn can have obstructive consequences on an active endometrium, and this would lead to the formation of a hematometra and the distension of the cavity, and sometimes adenomyosis.

Minimally Invasive Therapy & Allied Technologies, Nov 3, 2021

PURPOSE The purpose of this systematic review was to assess the characteristics of endobags prese... more PURPOSE The purpose of this systematic review was to assess the characteristics of endobags present in the market, the weight of specimen removed, complications of the operations and time required for in-bag morcellation in women undergoing laparoscopic gynecologic surgeries. MATERIAL AND METHODS We performed a systematic review, including prospective and retrospective studies, with or without randomized allocation of the patients, using endobags in laparoscopic gynecologic surgeries. We extracted data about study design, type and price of bag used, type of surgical procedure, specimen weight, mean time for morcellation and for total surgical procedure, complications. RESULTS We included 11 studies, including a total of 1160 patients, in which the investigators used MorSafe, Endocatch II autosuture, More-Cell-Safe, Endocatch, EcoSac and LapBag. A wide range of specimens were morcellated with the largest successfully morcellated specimen weighing 2314 gr. Only half of the studies comparing uncontained and contained morcellation found a significant increase of total operative time. Finally, the number of complications was not increased when endobag was used. CONCLUSION According to our systematic review, in-bag (contained) morcellation can be considered as a safe and unexpensive option, associated with a very low number of complications, even with large specimens.

Current genomics-driven precision oncology identifies actionable mutations in < 10% of cancer ... more Current genomics-driven precision oncology identifies actionable mutations in < 10% of cancer patients. Pediatric cancer is especially challenging due to limited mutations and fewer genomics-guided options. Functional precision medicine (FPM) addresses this by integrating genomic profiling with rapid, high-throughput functional ex vivo drug testing on live patient-derived cells. However, there is lack of FPM prospective data showing clinical utility in pediatric cancers. In this prospective, non-randomized, single-arm study (NCT03860376), we investigated feasibility and impact of FPM in pediatric/adolescent with refractory/relapsed solid and hematologic cancers. Of 25 patients, 19 (76%) had FPM data reviewed by the FPM tumor board within four weeks (FPMTB), meeting the primary outcome of the study. Additionally, six patients received FPM-guided treatment. Among these 6 patients, 83% (5 patients) experienced a greater than 1.3-fold improved progression-free survival compared to th...

Journal of Minimally Invasive Gynecology

Kansas Journal of Medicine

Italian Journal of Gynaecology and Obstetrics, 2022

CASE REPORT Laparoscopic management of a 13 weeks viable ectopic cesarean section Scar pregnancy:... more CASE REPORT Laparoscopic management of a 13 weeks viable ectopic cesarean section Scar pregnancy: a case report. Running title: Scar pregnancy laparoscopic management.

International Journal of Clinical Research

Background: A unicornuate uterus with a rudimentary horn is a rare Mullerian anomaly with few cas... more Background: A unicornuate uterus with a rudimentary horn is a rare Mullerian anomaly with few cases reported in the literature. The symptoms vary depending on the functionality of the endometrial cavity and the presence of an obstruction. Adenomyosis is a disease defined as areas of endometrial glands and stroma present within the myometrium. Reports describing adenomyosis in relation to the Mullerian anomalies are scarce. Case Report: We present a 20-year-old middle eastern woman admitted for chronic pelvic pain and abdominal distension. Pelvic ultrasound revealed a unicornuate uterus with an adjacent mass of 10 x 8 cm. An MRI (Magnetic Resonance Imaging) was performed, and a left unicornuate uterus was demonstrated. On the right side, a large non-communicating rudimentary horn with features suggesting diffuse adenomyosis was found. Laparoscopic removal of the horn was performed successfully, and the extraction of the specimen was made by a power morcellation containment system. Th...

Journal of Pharmacognosy and Phytotherapy, 2021

Laurus nobilis, commonly known as bay, is used in folk medicine as a remedy for many ailments. Th... more Laurus nobilis, commonly known as bay, is used in folk medicine as a remedy for many ailments. The present study investigates the protective effect of L. nobilis leaves extract against high fat diet-induced type 2 diabetes in rats. Animals were divided into group 1 (control), groups 2, 3, and 4 (bay leaves aqueous (AQ) extracts; 50, 100, and 250 mg/kg of body weight, respectively), and groups 5, 6, and 7 (bay leaves methanol/acetone (MeAc) extract; 50, 100, and 250 mg/kg of body weight, respectively). Animals were fed an isocaloric high fat diet for four weeks. The intake of bay leaves extracts was associated with a significant decreases in serum levels of glucose (AQ, 100 and 250 mg/kg; MeAc, 50, 100, and 250 mg/kg) and serum triglyceride (AQ, 250 mg/kg; MeAc, 100, and 250 mg/kg) as well as lower abdominal fat (all AQ and MeAc groups) and body weight gain (MeAc groups only). In conclusion, L. nobilis leaves extract intake provides a protective remedy against high fat diet-induced type 2 diabetes.

Facts, Views and Vision in ObGyn, 2021

Autoamputation of the ovary is a rare occurrence of uncertain aetiology with only a few cases rep... more Autoamputation of the ovary is a rare occurrence of uncertain aetiology with only a few cases reported in literature. It usually develops following ovarian torsion or torsion of a dermoid cyst with subsequent necrosis of the pedicle and autoamputation. We present the case of a 42 year-old woman was admitted for a laparoscopic removal of a right ovarian cyst. The ultrasound showed a right ovarian cystic mass suggestive of a cystadenoma, and another heterogeneous small echogenic cyst of the left ovary. During laparoscopy, excessive bleeding from the ovarian cortex complicated the cyst stripping and, considering the age of the patient and the emerging technical difficulty of the procedure, a total adnexectomy for the right ovary was performed. While exploring the small cyst on the left ovary, a dermoid cyst was found in the Douglas pouch. This finding could be interpreted as an autoamputation of the adnexa due to an asymptomatic torsion of a previous ovarian cyst arising from the left ...

Minimally Invasive Therapy & Allied Technologies

Purpose: The purpose of this systematic review was to assess the characteristics of endobags pres... more Purpose: The purpose of this systematic review was to assess the characteristics of endobags present in the market, the weight of specimen removed, complications of the operations and time required for in-bag morcellation in women undergoing laparoscopic gynecologic surgeries. Material and methods: We performed a systematic review, including prospective and retrospective studies, with or without randomized allocation of the patients, using endobags in laparoscopic gynecologic surgeries. We extracted data about study design, type and price of bag used, type of surgical procedure, specimen weight, mean time for morcellation and for total surgical procedure, complications. Results: We included 11 studies, including a total of 1160 patients, in which the investigators used MorSafe, Endocatch II autosuture, More-Cell-Safe, Endocatch, EcoSac and LapBag. A wide range of specimens were morcellated with the largest successfully morcellated specimen weighing 2314 gr. Only half of the studies comparing uncontained and contained morcellation found a significant increase of total operative time. Finally, the number of complications was not increased when endobag was used. Conclusion: According to our systematic review, in-bag (contained) morcellation can be considered as a safe and unexpensive option, associated with a very low number of complications, even with large specimens.

Nature medicine, Apr 11, 2024

Children with rare, relapsed or refractory cancers often face limited treatment options, and few ... more Children with rare, relapsed or refractory cancers often face limited treatment options, and few predictive biomarkers are available that can enable personalized treatment recommendations. The implementation of functional precision medicine (FPM), which combines genomic profiling with drug sensitivity testing (DST) of patient-derived tumor cells, has potential to identify treatment options when standard-of-care is exhausted. The goal of this prospective observational study was to generate FPM data for pediatric patients with relapsed or refractory cancer. The primary objective was to determine the feasibility of returning FPM-based treatment recommendations in real time to the FPM tumor board (FPMTB) within a clinically actionable timeframe (<4 weeks). The secondary objective was to assess clinical outcomes from patients enrolled in the study. Twenty-five patients with relapsed or refractory solid and hematological cancers were enrolled; 21 patients underwent DST and 20 also completed genomic profiling. Median turnaround times for DST and genomics were within 10 days and 27 days, respectively. T re at ment r ec om me nd ations were made for 19 patients (76%), of whom 14 received therapeutic interventions. Six patients received subsequent FPM-guided treatments. Among these patients, five (83%) experienced a greater than 1.3-fold improvement in progression-free survival associated with their FPM-guided therapy relative to their previous therapy, and demonstrated a significant increase in progression-free survival and objective response rate compared t o t h o se o f e i g ht n on-g ui ded patients. The findings from our proof-of-principle study illustrate the potential for FPM to positively impact clinical care for pediatric and adolescent patients with relapsed or refractory cancers and warrant further validation in large prospective studies. ClinicalTrials.gov registration: NCT03860376. Cancer is the leading cause of disease-related death for children and teenagers in the United States. Despite improvements in survival for patients with cancers like acute lymphoblastic leukemia, progress for other high-risk, relapsed or refractory pediatric cancers remains challenging 1. These patients typically have few established treatment options, in spite of advancements in standard therapy 2,3. Genomics-guided precision oncology 4 aims to provide pediatric and adolescent patients with matched treatments based on molecular

Critical Care Medicine, Dec 13, 2023

Kansas journal of medicine, Nov 29, 2023

Cureus, Dec 28, 2023

Isolated testicular involvement in pediatric lymphoma is rare and poses diagnostic challenges. In... more Isolated testicular involvement in pediatric lymphoma is rare and poses diagnostic challenges. In this study, the case of an isolated testicular B-lymphoblastic lymphoma in a 9-year-old boy is discussed with an emphasis on the difficulties in diagnosing and treating such an unusual presentation. This example illustrates the importance of considering lymphoblastic lymphoma in the differential diagnosis of an unidentified source of testicular enlargement. Furthermore, it highlights the possible efficacy of systemic chemotherapy with or without surgical excision. The article advances our knowledge of this unusual clinical situation.

Kansas journal of medicine, Nov 28, 2022

Journal of Medical Case Reports, Sep 5, 2020

Background: Coughing is considered an important mechanism that helps the body get rid of foreign ... more Background: Coughing is considered an important mechanism that helps the body get rid of foreign substances or prevent their entry into the tracheobronchial tree. Infrequently, after the onset of coughing, patients presenting with persistent chest pain are found to have rib fractures. Among the cases reported for cough-induced rib fractures, the maximum number of fractured ribs was found to be four. Case presentation: In this report, we present a case of a healthy 50-year-old Lebanese smoker who developed a total of six fractures in five ribs, asymmetrically, after coughing for 2.5 months. Conclusion: This case report is, to our knowledge, the first to describe six cough-induced rib fractures in a smoker without an underlying predisposition.

Facts, views & vision in ObGyn, Jun 30, 2021

Autoamputation of the ovary is a rare occurrence of uncertain aetiology with only a few cases rep... more Autoamputation of the ovary is a rare occurrence of uncertain aetiology with only a few cases reported in literature. It usually develops following ovarian torsion or torsion of a dermoid cyst with subsequent necrosis of the pedicle and autoamputation. We present the case of a 42 year-old woman was admitted for a laparoscopic removal of a right ovarian cyst. The ultrasound showed a right ovarian cystic mass suggestive of a cystadenoma, and another heterogeneous small echogenic cyst of the left ovary. During laparoscopy, excessive bleeding from the ovarian cortex complicated the cyst stripping and, considering the age of the patient and the emerging technical difficulty of the procedure, a total adnexectomy for the right ovary was performed. While exploring the small cyst on the left ovary, a dermoid cyst was found in the Douglas pouch. This finding could be interpreted as an autoamputation of the adnexa due to an asymptomatic torsion of a previous ovarian cyst arising from the left ovary. Medical errors could occur due to lack of knowledge, expertise, as well as lack of training and surgical skills, but also due to an unfortunate association of very rare confounding factors. Even in the hands of experts, following the basic rules of surgery remains a milestone in teaching and preventing surgical complications.

International Journal of Clinical Research, Jun 4, 2022

Background: A unicornuate uterus with a rudimentary horn is a rare Mullerian anomaly with few cas... more Background: A unicornuate uterus with a rudimentary horn is a rare Mullerian anomaly with few cases reported in the literature. The symptoms vary depending on the functionality of the endometrial cavity and the presence of an obstruction. Adenomyosis is a disease defined as areas of endometrial glands and stroma present within the myometrium. Reports describing adenomyosis in relation to the Mullerian anomalies are scarce. Case Report: We present a 20-year-old middle eastern woman admitted for chronic pelvic pain and abdominal distension. Pelvic ultrasound revealed a unicornuate uterus with an adjacent mass of 10 x 8 cm. An MRI (Magnetic Resonance Imaging) was performed, and a left unicornuate uterus was demonstrated. On the right side, a large non-communicating rudimentary horn with features suggesting diffuse adenomyosis was found. Laparoscopic removal of the horn was performed successfully, and the extraction of the specimen was made by a power morcellation containment system. The patient was discharged uneventfully the second day after the surgery, and the pathology result confirmed the presence of diffuse adenomyosis. Conclusion: Non-communicating rudimentary horn is a rare finding manifesting as different symptoms in young women. The enlargement of the horn can have obstructive consequences on an active endometrium, and this would lead to the formation of a hematometra and the distension of the cavity, and sometimes adenomyosis.

Minimally Invasive Therapy & Allied Technologies, Nov 3, 2021

PURPOSE The purpose of this systematic review was to assess the characteristics of endobags prese... more PURPOSE The purpose of this systematic review was to assess the characteristics of endobags present in the market, the weight of specimen removed, complications of the operations and time required for in-bag morcellation in women undergoing laparoscopic gynecologic surgeries. MATERIAL AND METHODS We performed a systematic review, including prospective and retrospective studies, with or without randomized allocation of the patients, using endobags in laparoscopic gynecologic surgeries. We extracted data about study design, type and price of bag used, type of surgical procedure, specimen weight, mean time for morcellation and for total surgical procedure, complications. RESULTS We included 11 studies, including a total of 1160 patients, in which the investigators used MorSafe, Endocatch II autosuture, More-Cell-Safe, Endocatch, EcoSac and LapBag. A wide range of specimens were morcellated with the largest successfully morcellated specimen weighing 2314 gr. Only half of the studies comparing uncontained and contained morcellation found a significant increase of total operative time. Finally, the number of complications was not increased when endobag was used. CONCLUSION According to our systematic review, in-bag (contained) morcellation can be considered as a safe and unexpensive option, associated with a very low number of complications, even with large specimens.

Current genomics-driven precision oncology identifies actionable mutations in < 10% of cancer ... more Current genomics-driven precision oncology identifies actionable mutations in < 10% of cancer patients. Pediatric cancer is especially challenging due to limited mutations and fewer genomics-guided options. Functional precision medicine (FPM) addresses this by integrating genomic profiling with rapid, high-throughput functional ex vivo drug testing on live patient-derived cells. However, there is lack of FPM prospective data showing clinical utility in pediatric cancers. In this prospective, non-randomized, single-arm study (NCT03860376), we investigated feasibility and impact of FPM in pediatric/adolescent with refractory/relapsed solid and hematologic cancers. Of 25 patients, 19 (76%) had FPM data reviewed by the FPM tumor board within four weeks (FPMTB), meeting the primary outcome of the study. Additionally, six patients received FPM-guided treatment. Among these 6 patients, 83% (5 patients) experienced a greater than 1.3-fold improved progression-free survival compared to th...

Journal of Minimally Invasive Gynecology

Kansas Journal of Medicine

Italian Journal of Gynaecology and Obstetrics, 2022

CASE REPORT Laparoscopic management of a 13 weeks viable ectopic cesarean section Scar pregnancy:... more CASE REPORT Laparoscopic management of a 13 weeks viable ectopic cesarean section Scar pregnancy: a case report. Running title: Scar pregnancy laparoscopic management.

International Journal of Clinical Research

Background: A unicornuate uterus with a rudimentary horn is a rare Mullerian anomaly with few cas... more Background: A unicornuate uterus with a rudimentary horn is a rare Mullerian anomaly with few cases reported in the literature. The symptoms vary depending on the functionality of the endometrial cavity and the presence of an obstruction. Adenomyosis is a disease defined as areas of endometrial glands and stroma present within the myometrium. Reports describing adenomyosis in relation to the Mullerian anomalies are scarce. Case Report: We present a 20-year-old middle eastern woman admitted for chronic pelvic pain and abdominal distension. Pelvic ultrasound revealed a unicornuate uterus with an adjacent mass of 10 x 8 cm. An MRI (Magnetic Resonance Imaging) was performed, and a left unicornuate uterus was demonstrated. On the right side, a large non-communicating rudimentary horn with features suggesting diffuse adenomyosis was found. Laparoscopic removal of the horn was performed successfully, and the extraction of the specimen was made by a power morcellation containment system. Th...

Journal of Pharmacognosy and Phytotherapy, 2021

Laurus nobilis, commonly known as bay, is used in folk medicine as a remedy for many ailments. Th... more Laurus nobilis, commonly known as bay, is used in folk medicine as a remedy for many ailments. The present study investigates the protective effect of L. nobilis leaves extract against high fat diet-induced type 2 diabetes in rats. Animals were divided into group 1 (control), groups 2, 3, and 4 (bay leaves aqueous (AQ) extracts; 50, 100, and 250 mg/kg of body weight, respectively), and groups 5, 6, and 7 (bay leaves methanol/acetone (MeAc) extract; 50, 100, and 250 mg/kg of body weight, respectively). Animals were fed an isocaloric high fat diet for four weeks. The intake of bay leaves extracts was associated with a significant decreases in serum levels of glucose (AQ, 100 and 250 mg/kg; MeAc, 50, 100, and 250 mg/kg) and serum triglyceride (AQ, 250 mg/kg; MeAc, 100, and 250 mg/kg) as well as lower abdominal fat (all AQ and MeAc groups) and body weight gain (MeAc groups only). In conclusion, L. nobilis leaves extract intake provides a protective remedy against high fat diet-induced type 2 diabetes.

Facts, Views and Vision in ObGyn, 2021

Autoamputation of the ovary is a rare occurrence of uncertain aetiology with only a few cases rep... more Autoamputation of the ovary is a rare occurrence of uncertain aetiology with only a few cases reported in literature. It usually develops following ovarian torsion or torsion of a dermoid cyst with subsequent necrosis of the pedicle and autoamputation. We present the case of a 42 year-old woman was admitted for a laparoscopic removal of a right ovarian cyst. The ultrasound showed a right ovarian cystic mass suggestive of a cystadenoma, and another heterogeneous small echogenic cyst of the left ovary. During laparoscopy, excessive bleeding from the ovarian cortex complicated the cyst stripping and, considering the age of the patient and the emerging technical difficulty of the procedure, a total adnexectomy for the right ovary was performed. While exploring the small cyst on the left ovary, a dermoid cyst was found in the Douglas pouch. This finding could be interpreted as an autoamputation of the adnexa due to an asymptomatic torsion of a previous ovarian cyst arising from the left ...

Minimally Invasive Therapy & Allied Technologies

Purpose: The purpose of this systematic review was to assess the characteristics of endobags pres... more Purpose: The purpose of this systematic review was to assess the characteristics of endobags present in the market, the weight of specimen removed, complications of the operations and time required for in-bag morcellation in women undergoing laparoscopic gynecologic surgeries. Material and methods: We performed a systematic review, including prospective and retrospective studies, with or without randomized allocation of the patients, using endobags in laparoscopic gynecologic surgeries. We extracted data about study design, type and price of bag used, type of surgical procedure, specimen weight, mean time for morcellation and for total surgical procedure, complications. Results: We included 11 studies, including a total of 1160 patients, in which the investigators used MorSafe, Endocatch II autosuture, More-Cell-Safe, Endocatch, EcoSac and LapBag. A wide range of specimens were morcellated with the largest successfully morcellated specimen weighing 2314 gr. Only half of the studies comparing uncontained and contained morcellation found a significant increase of total operative time. Finally, the number of complications was not increased when endobag was used. Conclusion: According to our systematic review, in-bag (contained) morcellation can be considered as a safe and unexpensive option, associated with a very low number of complications, even with large specimens.