Description

One of the limitations of minimal access surgery is difficulty in the retrieval of tissue. Previously surgeons were reluctant to perform many of the advanced surgical procedures due to this difficult procedure. New techniques for removing tissue have helped increase the number and types of laparoscopic surgeries that can be done laparoscopically. Safe removal of tissue is an important consideration in laparoscopic surgery and applies to all specimens irrespective of whether they are thought to be benign or malignant. The importance of wound protection is shown by considering laparoscopic cholecystectomy for symptomatic gallstone disease. Most of the gallbladders at the time of retrieval can be squeezed out through an unprotected port wound. At the time of extraction, the exit wound must be of sufficient size, and wound protection should be used to ensure that there is no contact between the specimen and the abdominal wall during removal. We all know that the incidence of unsuspected gallbladder cancer is between 0.5 and 1 percent and there are reported cases of port site tumor nodules because of implantation of tumor cells after extraction of the gallbladder through an unprotected wound.