Organ retrieval systems for endoscopic nephrectomy: a comparative study

Laparoscopic or retroperitoneoscopic interventions such as nephrectomy or tumor 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 LapSacs 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, because of its simplicity, it requires a certain laparoscopic expertise and involves a learning curve. Newly developed retrieval systems (i.e., LapBag, Extraction Bag, Endo-Catch) offer some advantages regarding the handling of the bag, which may be particularly useful during retroperitoneoscopic nephrectomy with a restricted working space. Retrieval systems (i.e., Endobag, Endopouch) with low resistance to tearing forces or permeability to tumor cells or bacteria (i.e., Espiner Bag) cannot be recommended for endoscopic nephrectomy.