[Ex-vivo Comparative Study on the Morcellation Efficiency of Different Morcellators].

Abstract

Anatomical enucleation of the prostate (AEEP) is an established treatment option for benign prostatic hyperplasia (BPH), regardless of prostate size. While advancements in laser technology have significantly improved the enucleation phase, the morcellation process has remained relatively unchanged, with limited innovations in morcellation devices. This study aimed to compare the efficiency of two morcellators in an ex-vivo model: the Piranha morcellator (Richard Wolf GmbH, Knittlingen) and a newly introduced, yet-to-be-commercialized device, the ActiveCut morcellator (Active Fiber Systems GmbH, Jena).The two morcellators were tested in a newly developed ex-vivo model. In both groups, reusable blades were tested ten times at comparable speed settings. For each trial, 60 grams of raw bovine heart tissue were morcellated. The efficiency of the morcellation was then analyzed. Primary endpoints included morcellation efficiency (g/min) and an evaluation of blade deterioration over repeated use. The mean values of continuous variables were compared using a t-test with standard deviation.A total of ten consecutive morcellation trials were conducted with each device. The ActiveCut demonstrated higher morcellation rates at 12.43 g/min, compared to 7.09 g/min with the Piranha morcellator (p<0.05). However, the ActiveCut showed a decline in efficiency over ten trials. In two cases, tissue had to be manually removed from the blade coupling during morcellation, whereas the Piranha morcellator maintained consistent performance without malfunctions.In this ex-vivo study, comparing the ActiveCut and Piranha morcellators, the ActiveCut exhibited higher morcellation efficiency. However, as the ActiveCut has not yet undergone clinical testing, future clinical studies are necessary to assess its safety and potential malfunctions before clinical implementation.