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Deep brain stimulator (DBS) devices are used for unilateral or bilateral stimulation of thalamus, subthalamus and globus pallidus to treat movement disorders. DBS can interfere with domestic and medical equipment such as electrocardiography (ECG), slow wave diathermy, electrocautery, peripheral nerve stimulators, pacemakers, external and implantable cardioverters and defibrillators. This case report describes a patient with such a device who presented for bilateral (B/L) cataract surgery.

Background: Tissue retrieval after laparoscopic myomectomy or total laparoscopic hysterectomy is always a challenge. To overcome this challenge, morcellation technique has been developed which involves fragmentation of the large tissue into smaller pieces to facilitate the ease of specimen extraction. Objective: To evaluate the feasibility of In-bag morcellation in tissue retrieval during laparoscopic surgeries. Materials and Methods: A retrospective study was undertaken at Firm Hospitals, Chennai over a period of one year from August 2020 to August 2021. All patients in whom In-bag morcellation was used for tissue retrieval were included in the study. Proven cases of malignancy were excluded. Demographic data was collected from patients and case records. Intra-operative details (including time for bag use and bag feasibility) was noted from the intraoperative video recordings. Results: Total of 63 patients were included in the study. Mean age of the patients was 37.8 ± 6.1 years, with a mean BMI of 27.3 ± 5.0kg/m2. The mean duration of surgery was 167.27 ± 56.2 minutes. Mean time taken for bag insertion was 2.92 ± 1.44 min. Average time taken for specimen insertion into the bag was 3.39 ± 2.65 min. Pneumoperitoneum was created in a mean time of 8.07 ± 2.51min. Mean morcellation time was 13.48 ± 9.55 min. Mean time taken for bag removal was 1.17 ± 0.83 min. Overall mean time taken for In-bag morcellation procedure (bag insertion to bag removal, including morcellation) was 29.04 ± 12.05 minutes. Average weight of the morcellated specimen was 665.6 grams. We noted a positive correlation between the specimen weight and total In-bag morcellation time. Bag was successfully utilized in 60 (95.2%) patients. The bag was twisted in three (4.8%) patients, whereas bag rupture was noted in two (3.2%) cases Conclusion: This retrospective analysis suggests that contained In-bag morcellation for tissue retrieval is a practical safe and feasible procedure. [ABSTRACT FROM AUTHOR]

A 47-year-old woman, P2L2, presented with short history of postmenopausal bleeding due to uterine leiomyoma with endometrial hyperplasia and ovarian cyst. She had no other associated symptoms. A total laparoscopic hysterectomy, with bilateral salpingo-oophorectomy was planned. Intraoperatively, while cauterizing the uterine artery on the right side, fibrous worm like strands were seen protruding out of the uterine vein and smaller strands were also seen protruding out from other pelvic veins The specimen on histopathology, confirmed fibrovascular tissue consistent with intravenous leiomyomatosis. [ABSTRACT FROM AUTHOR]