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10.5005/jp-journals-10033-1183
REVIEW ARTICLE Different Techniques of Tissue Retrieval from Abdominal Cavity during Minimal Access Surgery
Different Techniques of Tissue Retrieval from Abdominal

Cavity during Minimal Access Surgery

Nuzhat Amer, Muhammad Amer, Rajineesh K Mishra

ABSTRACT used but still the chance of spillage in case when perforation
of the tissue inside the bag. 5
Minimally access laparoscopic surgery has undergone rapid
development in last decade. It has many advantages but one of Specimen retrieval bags used for removal of excised
the challenges is the tissue retrieval from the surgical site. Large mass. It can avoid the spillage of the cyst and contamination
specimen can be retrieved after enlarging the port site but this
is against the concept of minimal access surgery (MAS). In this of the wound (Fig. 1). The bags generally require 10 to
article, we reviewed the literature to analyze the different 12 mm port. 2
methods of tissue retrieval during MAS. Tissue retrieval using Many types of specimen retrieval bags have been
the endobag for small to medium-sized specimens is straight described, including Nadiad bag, condom, modified zipper
forward through the umbilical trocar port. For larger specimens
morcellation, delivery through colpotomy or hand-assisted bag. Commercial bags can be costly and difficult to use
laparoscopic surgery was used to retrieve the specimen. All and are available only in standard size. Some authors
these methods help to keep the incision size small hence describe bags from surgical glove finger (powder free) but
improving the surgical outcome with minimal complications and
early recovery. it can tear off during traction through abdominal wall. This
can be minimized by making purse string suture around the
Keywords: Laparoscopic tissue retrieval, Colpotomy, Endobag,
Laparoscopic tissue retrieval sac, Morcellator. opening (Fig. 2). 6
How to cite this article: Amer N, Amer M, Mishra RK. Different
Techniques of Tissue Retrieval from Abdominal Cavity during
Minimal Access Surgery. World J Laparosc Surg 2013;6(2):63-68.
Source of support: Nil
Conflict of interest: None declared

INTRODUCTION
Laparoscopic surgery has been known by surgeons since
1980. After the advent of laparoscopic surgery, it has
undergone rapid development in last decade. Laparoscopic
surgery has many advantages, like less tissue dissection,
less need of analgesia postoperatively, better cosmetic
aspect, less intraoperative and postoperative complications
and early return to work. 1
In laparoscopic surgery, one challenge is to retrieve the Fig. 1: Endobag for tissue retrieval in MAS
specimen from the abdominal cavity with minimal spillage
as spillage of the content may cause dissemination of
disease, infection or malignancy. Spillage rate depends upon
the size of the mass, surgical expertise and route of removal
of the tissue. Spillage rate of dermoid cyst by laparoscopy
is 15 to 100% as compared to 4 to 13% in laparotomy. 2
One method of retrieval of specimen from the abdomen
is to enlarge one of the laparoscopic trocar incisions but it
is against the concept of minimal access surgery (MAS). 3
Tissue retrieval through port site may cause contamination,
implantation and port site hernia formation. 4
Transumbilical port is most thinnest and most distensible
portion of the anterior abdominal wall. As this technique
may be satisfactory for simple cyst or tissue but challenging
in cases of dermoid cyst of larger sizes. Endobags will be Fig. 2: Endobag made with surgical glove
World Journal of Laparoscopic Surgery, May-August 2013;6(2):63-68 63