port closure under visual guidance, before or after cannula removal [22, 23]. A number of systems have been developed to facilitate closure. Most work by introducing suture under visual guidance to ensure appropriate closure of the site (Figure 4.24).
For port closure, the suture enters and exits the abdominal wall through the cannula site skin incisions, which are often quite small. To facilitate correct suture placement, many port closure systems include a suture guide (Figure 4.25).
Figure 4.25 Many port closure systems utilize a suture guide to facilitate placing the suture through the small cannula skin incision.
References
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15 15 Surgeons, S.F.L. (2010). Prevention and management of laparoendoscopic surgical complications: laparoscopic trocar complications. http://laparoscopy.blogs.com/prevention_management_3/2010/11/laparoscopic‐trocar‐complications.html (accessed 10 October 2020).
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22 22 Shaher, Z. (2007). Port closure techniques. Surg. Endosc. 21: 1264–1274.
23 23 Mikhail, E. and Hart, S. (2014). Laparoscopic port closure. Surg. Technol. Int. 24: 27–33.
4.3 Miscellaneous Surgical Instrumentation
Penny J. Regier and W. Alex Fox‐Alvarez
Key Points
Specimen retrieval bags allow for extraction of tissue with reduced risk of bacterial or neoplastic contamination.
Single‐use integrated suction and irrigation devices are commercially available, but separate options for resterilization are also available.
Wound protector and retractor devices are very useful for increased surgical exposure and port protection.
Specimen Retrieval Bags
Prior to the development of specimen retrieval bags, minimally invasive surgeons removed intracorporeally resected tissue through unprotected port sites and small incisions. Manipulating infectious or neoplastic specimens through port incisions can lead to the uncommon but serious complication of port‐site metastasis or infection [1, 2]. The use of a retrieval bag allows for a contained extraction of potentially harmful tissue within an impermeable pouch and has been documented to reduce port or incision site contamination [3–6]. In veterinary medicine, specimen retrieval bags have been most often reported for use in minimally invasive cholecystectomy and tumor resections in the thorax and abdomen [7–9].
