The morcellator knife: a new laparoscopic instrument for supracervical hysterectomy and morcellation.

BACKGROUND: Cutting the cervix, morcellation, and extraction of the uterus and myomata remain major problems in endoscopic surgery. We developed an efficient, safe, reusable, and inexpensive instrument to cut the cervix and morcellate the uterus and myomata: the morcellator knife. INSTRUMENT: The morcellator knife is a classic lancet with an interchangeable blade, transformed into an endoscopic instrument that can be inserted easily through a 10-mm-diameter trocar. The blade has an automatic retraction system and is set in the standby position, ensuring security. Cutting the cervix and uterine or myoma fragmentation are easy. The mass to be cut is held between two grasping forceps for easy cutting with the blade, under permanent visual control. After morcellation, extraction of the masses is performed through a posterior culdotomy. EXPERIENCE: We have used this morcellator knife in 54 subtotal hysterectomies and 16 myomectomies. There were no complications during the procedures. Morcellation lasted 3-14 minutes and involved the use of an average of two to three blades. CONCLUSION: The morcellator knife is a simple, safe, reusable, and inexpensive instrument with a low maintenance cost