The "remote control" laparoscopic bag: a simple technique to remove intra-abdominal specimens.

Abstract

To facilitate extraction and avoid intra-abdominal spillage during laparoscopic removal of adnexal masses, various designs and sizes of endopouches (bags) have been used. We describe a simple technique using a special laparoscopic bag that requires no additional instruments to hold, open, or close the bag. The laparoscopic bag can be prepared from the sterile wrapping of disposable surgical items (eg, suction tubing) and two long sutures. The bag is introduced through the cannula of the laparoscope and is unfurled. By manipulation of the two long sutures threaded through the neck of the bag, the surgeon can easily open and close it. We have performed this procedure "in vitro" on many occasions to ensure that the drawstring technique works. The laparoscopic bag has been used successfully in three patients undergoing oophorectomy and salpingo-oophorectomy. Our experience shows that this type of laparoscopic bag is easy to use and safe, reduces operative time, and is cost effective. Because the bag can be large, operating inside the bag is also possible. Our drawstring design allows easy manipulation of a laparoscopic bag to facilitate its opening and closure.