Methods for specimen removal from the peritoneal cavity after laparoscopic excision

Key content Mini laparotomy (suprapubic, transumbilical, ancillary port‐site) and posterior colpotomy are methods that have been used for the removal of specimens excised laparoscopically, with the use of morcellators and endoscopic bags growing in popularity in recent years. The size, cystic versus solid component and the risk of malignancy are essential factors influencing the route of specimen retrieval. The risk of spillage (especially in suspected early malignancy) has to be considered during excision and retrieval. Natural orifice transluminal endoscopy (NOTES) may be the operative and retrieval route of the future. Learning objectives To be aware of the different methods and routes of retrieving laparoscopically excised specimens. To be aware of the risks associated with each method and route. To review the factors that will influence the optimal choice of route and method. Ethical issues In the age of specialisation, a clinician who is not specially trained in operative laparoscopic surgery should not be practicing it. To minimise complications, the excision and retrieval of specimens via minimally invasive incisions should be limited to specially trained individuals.