Endoscopic Specimen Retrieval Bag (EndoBag)

Due to the advantages of laparoscopic surgery as a minimally invasive surgery over open abdominal surgery, physicians significantly prefer this method, so the rate of use of this method is very high and it is still growing. Retrieval Bag (Endobag) is one of the laparoscopic surgical instruments which is used for the collection and extraction of tissue specimens.

What is an endoscopic specimen retrieval bag (Endobag)?

The retrieval bag or endo bag is a disposable device used for retrieving/removing excised pathological tissue/organ/specimen such as the appendix, gallbladder, ovaries, fibroid tumors, and other tissues in laparoscopic  surgeries.

The retrieval bag consists of a flexible plastic bag that opens after being placed in the body cavity. The bag can stay inside the body cavity and be filled with tissue a few times during the hole surgery and removed just before the surgery is finished.

Endobag Application

It’s a long time since the endoscopic specimen retrieval bag (endobag) is in use in minimally invasive laparoscopic surgeries.

Recently, the incidence of concerns about the spreading of malignant cells while removing infected components and cancerous tissue and so has led to the increased use of endoscopic specimen recovery bags for safe ejection.

Endobags are used to remove excess cysts and masses to prevent leakage of the cyst or mass contents into the abdominal cavity, such as removing tissue (in cases of biopsy), or cyst (in cases of cystectomy).

In these cases, the retrieval bag is placed inside the abdominal cavity (in some cases it is possible the fluid inside it will be suctioned). This was done to prevent the contents of the cyst from leaking (which may release contents and progress disease) and was welcomed. So, removing a benign mass or cyst with a retrieval bag can also be safer.

Types of retrieval bag

Although the use of specimen retrieval bags for tissue extraction in surgeries has been very satisfactory, it should be noted that the available endobags are very different in construction, size, durability, and shape. Therefore, choosing the suitable bag is very important.

AJP Endobags are varied in size (bag diameter and capacity). The most common specimen bags for laparoscopic surgeries are 10 to 15 cm in diameter and can easily bring out most masses.

These bags usually require 10 to 12 mm of space to enter the abdomen (created by the trocar).

Endoscopic specimen bags (Endobags) are also used in two types, automatic and manual. In the automatic type, the bag can be opened automatically after entering the abdominal cavity and positioned by the handle.

Another type is the manual type, in which the bag after entering the abdominal cavity and opening needs to be positioned by an instrument that holds the edges of the.

Why use the EndoBag?

• Since the incisions are small in minimally invasive surgeries, surgeons have a challenge in extracting large specimens from small incisions. One approach is to use a specimen retrieval bag (endobag).
• After the tissue or specimen is removed, the specimen is placed inside the specimen retrieval bag to be extracted, thus minimizing the possibility of the specimen coming into contact with the abdominal cavity and the incision site.
• Using the specimen retrieval bag prevents the spreading of infection and prevents the fluid and contents of the specimen or mass from spilling into the peritoneal cavity.
• It minimizes the risk of specimen outlet metastasis in cases of dangerous cancerous specimens.

AJP Retrieval Bag (EndoBag)

The AJP automatic retrieval bags are available in three sizes (150, 450 and 700 cc) for use in laparoscopic procedures. The following are the most important advantages of this product:

• Sterile
• Disposable
• Flexible plastic bag
• Large, easily accessible opening
• Highly tear-resistant
• Preventing liquids from leaking out the bag
• Opens automatically in the abdominal cavity
• It is held open by rigid wire arms during tissue capture.
• Avoiding any serrations and weak points

Pathology

In most cases (using specimen bags), surgeons have given good feedback on what to expect before and after surgery, based on imaging studies and physical examinations.

Two prevalent features used for surgical planning and the use of sampling tools are the specimen size (dimensions) and the type of tissue (solid, cystic, soft, or mixed tissue).

The mass size can be from less than 1 cm to larger than a 20-week-old uterine fibroid.

The type of tissue is carefully examined because soft and scaly masses such as ovarian and gallbladder cysts compared to solid or calcified tumors such as the fibromatous uterus, a part of the intestine or spleen, or a large dermoid with solid components, fit inside the bag and easier comes out.

Sample shape is also an important criterion for selecting a specimen bag.

Sample discharge bags are conical in shape and with different dimensions, so if care is not taken in choosing a bag that fits the dimensions of the sample or tissue, the specimen may not fit completely in it, and in this case, the specimen or tissue removal operation may be unsafe and ineffective.