Evaluating the Role of Retrieval Bags in Mitigating Contamination During Minimally Invasive Colorectal Surgery

Area of Science:

• Colorectal Surgery
• Surgical Microbiology
• Minimally Invasive Surgery

Background:

• Intraoperative bacterial and tumor cell spillage are concerns in colorectal surgery.
• Minimally invasive techniques may alter spillage patterns.
• The efficacy of specimen retrieval bags in preventing spillage requires evaluation.

Purpose of the Study:

• To quantify intraoperative bacterial and tumor cell spillage during minimally invasive colorectal surgery.
• To assess the protective role of specimen retrieval bags against spillage.
• To identify factors influencing contamination during these procedures.

Main Methods:

• A multicenter, prospective observational study.
• Inclusion of patients undergoing laparoscopic colorectal surgery for adenocarcinoma, polyps, or diverticulitis.
• Collection of intraoperative samples for microbiological and cytological analysis at three stages: post-pneumoperitoneum, post-ligation/division, and post-specimen extraction.

Main Results:

• Bacterial contamination significantly increased throughout the procedure, from 11.4% to 67% (p < 0.001).
• Bacterial growth was detected exclusively in the post-extraction sample in 37.5% of cases.
• No clinically relevant tumor cells were found, though atypical cells were noted in one post-extraction sample.

Conclusions:

• Bacterial contamination escalates during minimally invasive colorectal surgery, peaking post-specimen extraction.
• Specimen retrieval bags show potential in limiting bacterial spillage.
• Current cytology methods did not demonstrate a protective effect of bags against tumor cell dissemination.