Search

Abstract Electromechanical morcellation—so called power morcellation—is a minimally invasive approach to remove bulky lesions such as uterine fibroids. The spread of benign and malignant tissue due to morcellation is a major concern that might limit the use of laparoscopic interventions. We present an in vitro evaluation of the safety characteristics of a four-port endobag with closable trocar sleeves, and describe physical properties of the bag that may or may not allow passage through the hole. In addition, we report our preliminary experience of this tool when used for laparoscopic supracervical hysterectomies. The behavior of the endobag during the extraction process was analyzed by extracting opened and re-sealed bags filled with 20 ml blue dye solution through a wooden template, with incisions measuring 10 to 24 mm. The endobag was used in 50 subtotal hysterectomies during the morcellation procedure. In the in vitro test, no dye loss was recorded for incisions measuring 11–24 mm. The mean force required to pull the bag through the template was inversely proportional to incision size. No bag rupture occurred during the surgical procedures. The mean time taken to prepare the bag for morcellation was 7.1 min (range, 4–14 min), the mean duration of subtotal hysterectomy was 53.4 min (range, 20–194 min). The mean weight of the removed body of the uterus was 113.8 g (range, 13–896 g), the mean weight of tissue and fluid remaining in the bag after morcellation 7.9 g (range, 0–39 g). In the in vitro setting, the improved endobag signifies greater patient safety during bag extraction, along with less tissue traumatization due to a smaller incision in the abdominal wall. The improved ergonomic features of the bag permit the insertion of three trocars in the lower abdomen and avoid closure of unused access ports. Our preliminary experience has shown that the device can be used under routine conditions. Failure rates will be evaluated in future studies.

Despite concerns about the loss of industry, industrial land, and buildings in high-value post-industrial cities, there is concurrently a renewed enthusiasm around the potential of “new” urban manufacturing and its contribution to the socio-economic diversity of cities. Yet, little is known about how planning policy can best support the retention and growth of urban manufacturing. To advance this agenda, this article proposes that we need a better understanding of industrial building typologies and resultant urban form. Using concepts developed by Julienne Hanson to analyse residential morphologies undergoing transformation under modernism, we apply these concepts to investigate the industrial, mixed-use contexts in two areas of London with concentrations of urban manufacturing—Hackney Mare Street and Old Kent Road. The research presented examines how both areas have evolved historically to produce distinctive urban tissues and a range of industrial building typologies. The article reveals that, despite territorial similarities in the late 19th century, the mixed land uses and smaller plot sizes of Hackney Mare Street have allowed for a more resilient development pattern, whereas the greater separation of land uses, large plot sizes, and inward-facing development in the Old Kent Road has facilitated its reimagination for large-scale regeneration. We conclude that greater attention needs to be paid to the relationship between urban manufacturing and built urban form if policies that aim to protect or support the revival of manufacturing in cities are to avoid negative unintended consequences.