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Different Techniques of Tissue Retrieval from Abdominal Cavity during Minimal Access Surgery

patients had better cosmesis, decreased postoperative pain, Tissue retrieval through colpotomy has been known
faster recovery and early return to work. 22 since long and now with the advent of MAS this has become
Wyman et al described robotic-assisted hysterectomy an important route for large-sized specimen retrieval. 20
and bilateral salpingo-oophorectomy through transvaginal Naturally, this method is only available in females. This
tissue retrieval by using anchor tissue retrieval system. These procedure can be used in morbid obese patients with good
patients were having atypical endometrial hyperplasia. results. 21,22 In robotic-assisted laparoscopic surgery,
22
There was no split or tear in the sac and this system colpotomy wound can be closed laparoscopically. Tissue
minimized the exposure of cancer bearing tissue to the retrieval through colpotomy has been found to be safe and
pelvis. 4 easy to learn method. There are minimal intraoperative and
postoperative complications, decreased hospital stay and
DISCUSSION early return to work. 4,5,22

With advent of minimally access surgery by laparoscopy,
the major challenge has been to find the easy and safe CONCLUSION
method of tissue retrieval from the surgical site. Enlargement Tissue retrieval in MAS is an important issue. Various
of trocar incision site is against the MAS and various methods are being used and new technologies are being
methods have been employed to overcome this problem. developed to make this procedure safe for the patient. For
It is important to retrieve the tissue from the abdominal smaller specimens, transumbilical route using endobag
cavity in such a way so it will not cause infection, technique and for larger specimens retrieval through
implantation of tumor cells or spillage of the contents into colpotomy seems reasonable at this moment. Use of
the abdominal cavity or tissue retrieval site. For this purpose, morcellator is time saving but can only be used in for tissues
various types of endobags have been described. There are which are supposed to be benign in nature. For large tissue
purpose built commercially available endobags but are resections and organ removal, HALS shows good promise.
expensive. Various do it yourself endobags have been
described in literature which claim to be inexpensive and REFERENCES
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World Journal of Laparoscopic Surgery, May-August 2013;6(2):63-68 67