Patent 2098630 Summary

CLAIMS
1. A laparoscopy bag for use in a trocar, the bag being of flexible material
and having traction strings at an open end thereof, the bag comprising a
working section and a hose-shaped part extending therefrom.
2. A bag according to claim 1 wherein the working section ends at the hose-
shaped part.
3. A bag according to claim 1 or claim 2 wherein the working section has a
main part of circular cross section and a lower part which tapers to the
hose-shaped part.
4. A bag according to claim 1 or claim 2 wherein the working section is
funnel shaped and tapers to the hose-shaped part.
5. A bag according to anyone of claims 1 to 4 wherein the hose-shaped part
comprises folding bellows.
6. A bag according to anyone of claims 1 to 5 wherein the hose-shaped part
has a diameter equal to or less than the diameter of the trocar.

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The document describes a laparosoopy bag the shape of which allows
the the closed bag holding the respected and dissected tissue to be
withdrawn through the trocar, so that none of the resected lumps
of tissue may penetrate into the abdominal cavity and any contami-
nation of the latter is thus prevented.
~aoarQecopy Bag
It is well known that for endoscapic operations (laparoscopy) the
abdominal cavity is not apened by an abdominal incision, but that
the instruments required as well as the optical system are intro-
duced through a trocar pushed through the abdominal wall, the
instruments being actuated from autside the abdominal cavity. To
the patient this surgical method is less traumatising than the
operations carried out so far which involved the apening of the
abdominal cavity. This procedure results in a smaller discomfort
to the patient. He has less pain, the wound heals more rapidly
and, correspondingly, the duration of hospitalization is reduced,
too. This surgical practice, however, meets its limits as saon as
large site tumors or large masses of tissue have to be removed
from the abdominal cavity. If such material cannot be removed in
bulk through the trocar the tumor and the inflamed tissue must be
dissected within the abdominal cavity and may give rise to a con
tamination of the latter and constitute, in particular in the case
of malign tumors, a danger to the patient because of the formation
mete s t a s a ~ a
In order to solve this set of problems so-called "laparoscopy
bags" have become known which are made of a flexible and durable
material and which can be closed by pulling strings at their upper
open end. This bag, hanging from the strings, is introduced into
the abdominal cavity through the trocar and is opened in the ab-

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2098630
dominal cavity where the tissue to be removed is planed in the
bag. After that the bag is closed by pulling the str~.ngs and its
upper o~>enable end is withdrawn from the abdominal wall together
with the trocar. Thereafter the tissue is dissected and the indi-
vidual lumps are taken out of thn small bag, whereupon the bag is
discarded. l~ltho~tgh this laparoscopy bag conetit.utes a considera-
ble improvement insofar as - at :least theoretically ~ no impurity
can get into the abdominal cavity, the withdrawal of the resented
and dissected t.is~sua is complicated and time-consuming. In addi-
tion, the danger still exists that fluxing the withdrawal of the
dissected tissue particles may be introduced into the path of a
vessel and, in the case of malign tumors, may give r~,sa to the
formation of metastases.
Beyond that, hose-shaped laparascopy bags have been known which
are filled with the resected and dissected lumps of tissue and
which are withdrawn through a trocar. These bags are provided with
a lap enabling the bag to be withdrawn. These bags, however, have
the essential shortcoming that no working space is provided whea~e
the surgical operation can ba carried out and where the lumps of
tissue can safely be dissected. Therefore a contamination of the
abdominal cavity cannot be excluded,
The purpose underlying the present invention is therefor~ a lapa-
roscopy bag allowing the in-toto withdrawal in the closed bag of
the resented and dissected tissue through the trocar, i.e, the
withdrawal of the closed bag filled with tissue, so that the dan-
ger of tissue particles penetrating into the vessels is excluded.
mhis aim is aahievgd by a laparoscopy bag according to claim 1.
The laparoscopy bag cansists of a working section sufficient in
size to accommodate the material to be resected. The ti.ssua dis-
- 30 seated therein drops into the hose-shaped part or is forced into
this hose~shapad reservoir when the bag has been closed and is
pulled into the trocar, so that the bag may be withdrawn as a who-
le. Th8 hose-shaped part serving as the reservoir has a diameter

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2098530
slightly smaller than that of the trocar. The hose-shaped part can
be conceived as a str$ight hose ar as a folded bellows.
Furth~r details of the invention and the handling are explained on
the base of the drawings, whereby
Fig. 1 is a schematic drawing of the laparoscopy bag
Fig. 2 is one design of the hose-shaped part
Fig, 3 is another design of the laparoscopy bag
Fig. 4 illustrates the positions of the trocar and the bag in the
abdominal cavity
Fig. 5 illustrates the withdrawal of the bag after the tissue to
be removed has been deposited in the bag and dissected.
Fag. Z schematically shows a laparoscopy bag 1 according to the
invention. The bag is subdivided into the working section z and
the hose-shaped reservoir 3. The working section 2 has a circular
Grpss section and and, like a funnel, is tapered off to the hose-
shaped reservoir. The upper ram 4 of bag 1 is provided with trac-
tion strings 5 for closing the bag. The diameter of reservoir 3 is
slightly smaller than that of the trocar used for the surgical
operation. In Fig. 1 a straight hoes is used as the reservai.r. The
lapaxoscopy bag 1 is made of a clear transparent foil with a cer-
tain strength enabling the bag tv be opened in the abdominal cavi-
ty and to retain the opened position. The material of the bag
shall be antistatic, pyrogen-free, non-toxic and sterilisable.
The working space of the working sECtion 2 usually has a diameter
of 15 cm but, depending on the volume bf tissue to bs resected,
bags having other dimensions can be imagined,
Fig. 2 showe a modification of the reservoir, i.e. a folded bel-
lows 6, allowing the available reservoir volume to be increased if
required.
Fig. 3 shows a laparoscopy bag the working section of which is
funnel-shaped, but which in the Qther aspects is identical with
the design according to Fig. 1. This modification is suitable for

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smaller lumps of tissue and for tissue having a soft consistency
which Can easily be dissected.
Friar to use the laparoscopy bang according to the invention is
either rolled up from the side of the reservoir to form a coil
which can simply be introduced into the abdominal cavity through
the tracer. Ancather possibility consists in accommodating the
working section in the hose-shaped reservoir 3, with the traction
strings freely projecting aver the reservoir. l:n they abdominal
cavity the bag can than easily be unfolded with the aid of two
instruments.
The application of the laparoscopy bag is explained in terms of
Figs 4 and 5. After the the diagnostic laparoscopy a tracer, by
preference of 2 cm, is applied through the abdominal. wall 9. xhe
sterile, folded bag is then introduced through this tracer auto
the abdominal cavity and is opened there using two blunt instru-
ments. This phase ie represented in Fig. 4, the two traction
strings being represented as projecting over the tracer. Of cour-
se, it is also possible to introduce the traction strings together
with the bag into the abdominal cavity and then to actuate the
traction strings by appropriate instruments. After that the tumor
or the tissue to be removed are resented and placed in the working
section of the bag. The tumor can then be dissected in the bag by
scissors or surgical knives, whereby care should be taken not to
damage the bag arid not to allow resected tissue to penetrate into
the abdominal cavity. As soon as the tissue 11 has been dissected
to such a degree that it can be accommodated in the reservoir 3
the bag is closed with the aid of the two traction strings. After
that the bag is drawn through the tracer by pulling the traction
strings. As soon as the bag has reached the tracer it is squeezed,
so that - because of the shape oP the bag according to the inven-
tion - the dissected tissue, as far as it has not yet slipped into
the reservoir, is forced from the working section of the bag into
the reservoir. This pc~sitian is shown in Fig. 5. After that the

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209863
complete bag, togathex with the tissue in the raserv~ir, can be
withdrawn groin the trocar without any problem. ~n this way it is
made aura that no tissue particls penetrate into the abdominal
cavity and that any contamination of the abdominal cavity is pre
y vented.