Entrapment and Exit

An Endocatchb device is introduced through the right-hand port incision, and the specimen is entrapped (Fig. 5). Smaller specimens are entrapped within the Endocatch (10 mm shaft), whereas larger specimens require the Endocatch II device which (15 mm shaft) which is introduced directly through the port-site incision. For larger specimens, an intentional peritoneotomy is occasionally created strictly for specimen entrapment. Intact specimen extraction is performed through an appropriate muscle-splitting incision (Gibson or Pfannensteil). Hemostasis is confirmed under lowered pneu-moretroperitoneal pressure and ports are removed under direct vision. Fascial closure is performed for all 10 mm or larger port sites using a 0-Vicryl suture.

FIGURE4 ■ Renal hilar control. Renal artery has been clip ligated and divided. Renal vein is circumferentially mobilized and controlled with gastrointestinal anastomosis stapler.

FIGURE5 ■ Specimen entrapment in bag. Self-opening mouth of bag facilitates deployment of bag and subsequent specimen entrapment in restricted retroperitoneal space. After specimen entrapment, mouth of bag is detached from metallic ring and closed by pulling on built-in drawstring (inset).

FIGURE4 ■ Renal hilar control. Renal artery has been clip ligated and divided. Renal vein is circumferentially mobilized and controlled with gastrointestinal anastomosis stapler.

FIGURE5 ■ Specimen entrapment in bag. Self-opening mouth of bag facilitates deployment of bag and subsequent specimen entrapment in restricted retroperitoneal space. After specimen entrapment, mouth of bag is detached from metallic ring and closed by pulling on built-in drawstring (inset).

bU.S. Surgical Corp., Norwalk, CT.

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