Endoscopic Specimen Retrieval Bag (Endobag)

Laparoscopic surgery, as a minimally invasive procedure, offers numerous advantages over open abdominal surgery. Due to its smaller incisions, faster recovery, and reduced postoperative complications, this technique has become the preferred choice for surgeons worldwide. Among the essential laparoscopic instruments is the Specimen Retrieval Bag (Endobag), a sterile and disposable device used for the safe collection and extraction of tissue specimens during surgery. In this article, we will discuss the function, applications, and types of endobags. We will also highlight their crucial role in preventing contamination during laparoscopic procedures.

What is an Endoscopic Specimen Retrieval Bag?

An endoscopic specimen retrieval bag, commonly known as an EndoBag, is designed to retrieve and remove excised tissues or organs such as the appendix, gallbladder, ovaries, fibroid tumors, and other pathological specimens during laparoscopic procedures.
The device consists of a flexible, transparent plastic bag that opens inside the abdominal cavity. It allows surgeons to collect tissue samples securely with minimum contamination. The bag can remain inside the cavity throughout the procedure and be removed at the end of surgery once the specimens are collected.

Endobag Application

The endobags have long been used in minimally invasive laparoscopic surgeries. In recent years, its use has increased due to growing concerns about the potential spread of malignant cells or infection during tissue removal. Endoscopic retrieval bags are mainly used to:

• Extract cysts and masses while preventing fluid leakage into the abdominal cavity.
• Remove biopsy specimens safely.
• Contain and remove potentially infectious or cancerous tissues to prevent contamination and metastasis.

In certain cases, the fluid inside the bag can be aspirated before removal to avoid leakage and disease progression. It makes the procedure safer even for benign masses and cysts.

Types of Specimen Retrieval Bags

Although the use of specimen retrieval bag has proven very effective, they differ significantly in design, material, capacity, and durability. Selecting the right bag for each procedure is crucial.

AJP endobags are available in various sizes and capacities, typically ranging from 10 to 15 cm in diameter, suitable for most laparoscopic procedures. They are introduced into the abdominal cavity through a 10–12 mm trocar port.

There are two main types of endobags:

• Automatic endobags: open and close automatically inside the abdominal cavity.
• Manual endobags: open and close manually using laparoscopic instruments.

The choice of endobag type depends on the specific surgical conditions and the surgeon’s preference.

Why Use an EndoBag?

During minimally invasive surgery, removing large tissue specimens through small incisions can be challenging. The use of a specimen retrieval bag helps overcome this limitation by:

• Preventing contact between the specimen and the abdominal cavity.
• Reducing the risk of infection and contamination.
• Preventing fluid or tissue content from spilling into the peritoneal cavity.
• Minimizing the risk of port-site metastasis in oncologic cases.

Thus, endobags play a vital role in maintaining sterility and patient safety during laparoscopic tissue removal.

AJP Endoscopic Specimen Retrieval Bags

AJP endoBags are sterile, disposable, and made from high-quality flexible materials. They are available in three sizes (150, 450, and 700 cc), suitable for various laparoscopic applications.

Key features and advantages of AJP automatic endoBags include:

• Sterile and single-use
• Made of durable, flexible plastic
• Large, easy-access opening
• Highly tear-resistant
• Leak-proof design
• Automatic deployment inside the abdominal cavity
• Rigid wire arms keep the bag open for convenient tissue placement
• Smooth structure with no serrations or weak points

These features ensure reliable performance and safety in every surgical procedure.

Pathology Considerations

Before surgery, surgeons evaluate the type and size of the specimen using imaging and examination, and accordingly select the appropriate endobag size. Two major factors influence the choice of specimen retrieval bag:

• Specimen dimensions (which can vary from under 1 cm to a large uterine fibroid)
• Tissue type (solid, cystic, soft, or mixed)

Soft or cystic specimens, such as ovarian or gallbladder cysts, fit easily within retrieval bags, whereas solid or calcified masses like fibroids or spleen tissue may require larger or specially shaped bags. Since retrieval bags are often conical in shape, choosing the appropriate size and form ensures safe, efficient, and contamination-free specimen removal.