Kidney retrieval after endoscopic nephrectomy

Abstract

Laparoscopic or retroperitoneoscopic interventions such as nephrectomy or tumour nephrectomy call for the removal of large quantities of tissue which can no longer be extracted via the relatively confined lumen of a cannula. For this purpose, a variety of organ retrieval systems have been designed and are commercially available with the aim of safe tissue retrieval. This paper summarizes the results of an experimental and clinical comparison of the most important organ entrapment systems suitable for endoscopic nephrectomy. The LapSac^R was the first organ bag especially designed for laparoscopic nephrectomy. Despite various new modifications of this entrapment system, it still represents one of the best alternatives and has been used worldwide with success. However, due to its simplicity it requires laparoscopic expertise. Newly developed retrieval systems (i.e. LapBag^R, Extraction Bag^R) offer some advantages regarding the handling of the bag which may be particularly usetul during retroperitoneoscopic nephrectomy with a restricted working space. Retrieval systems (i.e. Endobag^R, Endopouch^R) with low resistance to tear forces or being permeable for tumour cells or bacteria (i.e. Espiner Bag^R) cannot be recommended for endoscopic nephrectomy.

Key Words:

• laparoscopy
• retroperitoneoscopy
• laparoscopic nephrectomy
• organ retrieval
• organ bag
• tissue morcellation