{
  "abstract": "Objective: To systematically evaluate the outcomes of in-bag versus no-bag morcellation during laparoscopic myomectomy and hysterectomy, focusing on safety.Data sources: Searches were conducted in Cochrane Library, Embase, and PubMed, covering studies from inception up to January 31, 2024.Methods of study selection: Inclusion of studies on females undergoing laparoscopic myomectomy and/or hysterectomy with in-bag morcellation, excluding series with fewer than 10 patients.Tabulation, integration and results: Data were synthesized using meta-analysis techniques, with sensitivity analyses for rare events, focusing on intraoperative complications (i.e. a composite outcome including conversion to laparotomy, bowel injury or, accidental injury to any viscus injury or vessel). The secondary outcomes include presence of parasitic fibroma, fragment of myometrium/uterus, blood transfusion, bleeding > 500mL, total operative time, postoperative length of stay, postoperative pain, conversion to laparotomy, postoperative complications and cost. From 1,970 published studies, we included 20 trials, enrolling 5,505 women in the in-bag and 37,283 women in the no-bag group. We included 9 trials in each subgroup: myomectomy and hysterectomy, enrolling 767 and 4678 women in the in-bag; 830 and 36380 women in the no-bag groups, respectively. We observed increased intraoperative complications compared to no-bag morcellation (OR 1.45, 95% CI 1.11;1.89) with a null heterogeneity (I²= 0%). The hysterectomy subgroup analysis showed a significant association between bag and intraoperative complications (OR 1.47, 95% CI 1.12;1.93) but not myomectomy (OR 1.00, 95% CI 0.29;3.43). We did not have enough information to conclude about the presence of parasitic fibroma, fragment of myometrium and costs. No statistical differences were observed concerning the other secondary outcomes.Conclusions: The use of containment bags in morcellation may increase the risk of intra-operative complications, particularly in case of hysterectomy. However, these events might not be directly related to bag use and could represent confounding factors. Further studies are needed to investigate in-bag morcellation.Registration: CRD42023478908 on the International Prospective Register of Systematic reviews. Registered November 19, 2024.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "name": "Gautier Chene"
    },
    {
      "name": "Laura Miquel"
    },
    {
      "name": "Aubert Agostini"
    },
    {
      "name": "Sofiane Bendifallah"
    },
    {
      "name": "Céline Solignac"
    },
    {
      "name": "Bernadette Darné"
    },
    {
      "name": "Solène Languille"
    },
    {
      "name": "Krystel Nyangoh Timoh"
    },
    {
      "name": "Marie Carbonnel"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9bbfswcye4dda.bib",
  "cited_by": 5,
  "doi": "10.1016/j.jmig.2025.07.002",
  "fulltext_url": null,
  "id": "9bbfswcye4dda",
  "issns": [
    "1553-4650"
  ],
  "landing_url": "https://hal.science/hal-05158169v1",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "hal",
      "0.sdv"
    ],
    [
      "hal",
      "1.sdv.mhep"
    ],
    [
      "hal",
      "2.sdv.mhep.geo"
    ],
    [
      "openalex",
      "2729|Uterine Myomas and Treatments"
    ]
  ],
  "openalex": "W4412043498",
  "pdf_url": "https://hal.science/hal-05158169/document",
  "pmcid": null,
  "pmid": "40623664",
  "published": "2026-10-30",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/9bbfswcye4dda.ris",
  "sources": [
    {
      "first_seen": "2026-11-01T12:20:46Z",
      "native_id": "hal-05158169",
      "source": "hal",
      "url": "https://hal.science/hal-05158169v1"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "hal:0.sdv",
      "subfield": "general"
    },
    {
      "field": "medicine",
      "origin": "hal:2.sdv.mhep.geo",
      "subfield": "reproductive-child"
    }
  ],
  "title": "Safety of in-bag morcellation during laparoscopic myomectomy and hysterectomy: a systematic review and meta-analysis",
  "title_text": "Safety of in-bag morcellation during laparoscopic myomectomy and hysterectomy: a systematic review and meta-analysis",
  "type": "peer-reviewed",
  "updated_at": "2026-11-01T12:20:46Z",
  "url": "https://research.draconitic.com/paper/9bbfswcye4dda",
  "venue": "Journal of Minimally Invasive Gynecology",
  "versions": []
}