INTRODUCTION: Laparoscopy and robotically assisted laparoscopy are being used for successful removal of increasingly larger specimens. One obstacle for surgeons, however, is the navigation of these large specimens into specimen retrieval bags for contained morcellation and removal to prevent dissemination of both benign and malignant tissue. OBJECTIVE: The purpose of this video is to provide guidance regarding manipulation and bagging of very large specimens using a robotic surgical system in order to improve efficiency and reduce surgeon reliance on surgical assistants. METHODS: To accomplish this goal, video footage was collected during 4 robotic hysterectomies for patients with large, leiomyomatous uteri and subsequently compiled and narrated to demonstrate useful techniques and common pitfalls with the bagging process. Our footage demonstrates robotic bagging using two distinct specimen bag models of differing construction, further broadening its application to a variety of surgical scenarios. RESULTS: Through this video, we demonstrate the ease with which robotic bagging of large specimens without a skilled assistant can be performed, thereby improving surgeon efficiency, independence, and adaptability while also reducing operative time. CONCLUSIONS: The robotic bagging of very large specimens reduces operative time while also improving surgeon speed and independence.
Fennell et al. (Fri,) studied this question.