Step 10 Drain Placement and Exit

Through the lateral most port site, a 19-French closed suction drain is placed and secured to the skin with 3-0 nylon suture. The working space is completely desufflated for several minutes and the operative field is reinspected under an intra-abdominal pressure of less than 10 mmHg. Hemostasis is obtained as needed. For the transperitoneal approach, any port sites of more than 8 mm is closed with No. 0 or No. 1 polyglactin ties using a fascial closure device, such as a Carter-Thomason system, under direct laparoscopic visualization.

If the specimen retrieval bag has not yet been extracted, the string of the cinch knot is brought through the anticipated exit site. All remaining trocars are removed under direct laparoscopic visualization. The extraction site is extended as needed for specimen removal, and closed with No. 0 polyglactin suture.

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