The specimen is placed in the bag and it is closed. Once the specimen is secured, the vaginal assistant applies downward traction onto the apparatus to extract the mass through the vaginal canal. The force applied to the specimen within the bag squeezes the viscera smaller facilitating its delivery Tofacitinib Citrate CP-690550 while simultaneously maintaining its architectural integrity. Furthermore, the specimen is removed without spillage or contamination. We have successfully retrieved large and challenging specimens that could barely fit in the 15mm Anchor Tissue Retrieval System (no. TR190SB2). The bag has a total volume capacity of 1860mL accommodating very large specimens. In addition, lubrication can be applied to the vagina or the outside of the bag without compromising the surgeon’s grip on the specimen.

Our experience suggests that the anchor bag is superior to the EndoCatch bag, as more force can be exerted upon the anchor product prior to bag failure. In addition, the anchor retrieval system can be used multiple times during a case. 3. Discussion In this paper we described a simple yet novel approach for specimen retrieval that promises to decrease operative time by facilitating safe and intact removal of large specimens following complex surgical procedures by minimally invasive approaches. The technique itself can be easily adopted and mastered by any minimally invasive surgeon. There is no additional cost associated with this technique, provided the surgeon was planning on using a retrieval system such as EndoCatch or the anchor product.

However, a prospective study would be imperative to compare the actual decrease in operative time, conversion to mini-laparotomy, and operative expenses associated with this new technique. Minimally invasive surgeries for gynecologic conditions are becoming more common due to the technical advantages of robotic surgery and the increasing comfort level and experience of advanced laparoscopic surgeons. As increasing complex procedures becomes a more commonplace for gynecological surgeons, technological advancements will need to be made to overcome new challenges facing minimally invasive surgeons. Facilitating retrieval of specimens, especially large or cancer-bearing organs, during minimally invasive surgery is paramount for the success of a minimally invasive procedure.

Dacomitinib This is most apparent for women undergoing surgery for endometrial cancer; however, this retrieval technique may have applications for even a wider range of minimally invasive surgical procedures. At our institution, we commonly use this technique to remove lymphatic tissue and large adnexal masses. This technique has also been used to remove an intact kidney and a segment of large intestine. Feasibility and safety of laparoscopic and robotic hysterectomies have been demonstrated in several studies [1�C4].