Laparoscopic pleat-bag technique: A simple solution to the common problem of endobag insertion
- PDF / 858,741 Bytes
- 2 Pages / 595.276 x 793.701 pts Page_size
- 70 Downloads / 192 Views
HOW I D O I T
Laparoscopic Pleat-Bag Technique: A Simple Solution to the Common Problem of Endobag Insertion Priyadarshan Anand Jategaonkar, Sudeep Pradeep Yadav
Abstract Background: Usage of the endobag is an essential component of extirpative laparoscopic surgery. However, there is scant reference in the literature to the techniques concerning this practice. We describe an easy-to-apply method of endobag insertion. Method: The polythene sleeve that enfolds the suction catheter is used. One edge of the bag is trimmed by 1 cm. The bag is then longitudinally pleated in a specific way. Subsequently, it is reverse-loaded into the metallic reducer and expelled into the peritoneal cavity. As it unfolds further, the mouth opens, and specimen loading becomes much easier and faster. Results: We have applied this method in over 3000 cases and found it to be a more “user-friendly” technique. Discussion: Specimen retrieval bags markedly reduce the rate of port site infection and metastasis. However, their laparoscopic manoeuvring may be a daunting task from its insertion to specimen loading. Concerns regarding its smooth handling may add to surgical stress, particularly after a lengthy surgery. Our pleat-bag technique seems productive in this regard. Moreover, it can also be applied to larger endobags. Conclusion: The technique of endobag pleating is simple and efficient. It may be considered a standard method of
specimen retrieval. Key words: Endobag, laparoscopy, pleating, specimen retrieval
Background
Method
The endobag has become an integral part of laparoscopic surgery for safe specimen extraction [1]. However, the commercially available types are expensive [2] and “home-made” bags may be difficult to handle intracorporeally. We describe a pleating method that facilitates quick and easy extracorporeal and intracorporeal manipulations of the endobag.
We use the readily available plastic bag covering of a suction tube for specimen retrieval. One lip of the bag is cut curved, followed by a V-cut at its centre. A 5 ml syringe is used to flush sterile water into the bag which is subsequently emptied. (Figure-1-Part-1) The bag is then longitudinally pleated with subcentimeter alternating pleats on anterior and posterior surfaces. (Figure 1, Parts 2 and 3) Once complete, the bag is reduced to a thick plastic sheet of subcentimeter width that can be easily reverseloaded into the metallic reducer. (Figure 1, Part 4) Once in the peritoneal cavity, it “springs open” by itself and can be further unfolded just by a gentle spreading manoeuvre with the two-hand technique. The V-cut is readily caught with the Maryland forceps before placing the specimen in the endobag. (Figure 1, Parts 5 and 6)
Dr. Priyadarshan Anand Jategaonkar; FNB (MAS), MS, DNB, MRCS(Ed), FACS(USA), MNAMS, FMAS, PGDHA Associate Professor & Minimal Access Surgeon; Department of General & Laparoscopic Surgery; Mahatma Gandhi Institute of Medical sciences, Sevagram, Wardha- 442102, Maharashtra, India Dr. Sudeep Pradeep Yadav; DNB, MBBS; Assistant Surgeon; Depar
Data Loading...
