How to cite: Rivera ME. Morcellation: How I Do It. Grand Rounds in Urology. October, 2025. Accessed Apr 2026. https://grandroundsinurology.com/morcellation-how-i-do-it/
Summary
Marcelino E. Rivera, MD, Assistant Professor of Urology, Indiana University, Indianapolis, Indiana, presents a focused, practical overview of morcellation for prostate tissue retrieval following enucleation. He begins by comparing commercially available morcellators, including PIRANHA, VersaCut, MultiCut Solo, DrillCut-X II, Cyber Blade, and Hawk Jaws, describing differences in blade motion, speed, sterility, and integration. Blade motion varies between rotating, oscillating, and reciprocating systems, which influences efficiency and safety.
Dr. Rivera stresses the importance of fully understanding one’s morcellation system, reinforcing the need to know the controls, suction function, and overall setup. He shares endoscopic images and videos of morcellation procedures, illustrating the working field.
Troubleshooting guidance is detailed and practical. Examples include how to respond to continuous suction leaks, cycling vacuum attempts, missing O-rings, damp valve components, and tissue clogging due to misalignment.
Dr. Rivera emphasizes that it is essential to understand device options, recognize their limitations, identify efficiency patterns, and monitor injury risk associated with specific systems.
Frontiers in Oncologic Prostate Care and Ablative Local Therapy (FOCAL) is an outstanding program on prostate imaging, transperineal interventions, and ablative treatments for prostate cancer and benign prostatic hyperplasia. Bringing together community-based, academic, and industry partners, FOCAL offers lectures by world-renowned faculty and hands-on training workshops on in-office transperineal interventions, fusion-guided prostate ablation and state-of-the-art BPH management with novel technologies.
ABOUT THE AUTHOR
Marcelino E. Rivera, MD, is an Assistant Professor of Urology at Indiana University in Indianapolis. Dr. Rivera specializes in complex kidney stone and benign prostatic hyperplasia (BPH) surgery including percutaneous nephrolithotomy (PCNL) and Holmium Laser Enucleation of the Prostate (HoLEP). His research interests include minimally invasive BPH techniques utilizing laser technology and renal stone disease.
Dr. Rivera earned his medical degree from the University of Illinois in Chicago. He then completed his residency in Urology at the Mayo Clinic in Rochester, Minnesota. Dr. Rivera subsequently completed a fellowship in Endourology at Indiana University. He is currently a member of the American Urologic Association.
