Design: Surgical video

Setting: All surgeries are performed laparoscopically with an umbilical mini - laparotomy for tissue extraction. We utilize a suprapubic port and 2 lateral lower quadrant ports for tissue bagging with the patient in lithotomy position. Surgeries are performed in an urban setting at a university hospital.

Patients or Participants: This technique is applied to any patient with a large tissue specimen that will require morcellation for tissue extraction. Patients must be a candidate for laparoscopic surgery. We routinely apply this technique for laparoscopic myomectomy and laparoscopic hysterectomy patients.

Interventions: Techniques for large specimen bagging and contained hand morcellation.

Measurements and Main Results: This video demonstrates our surgical steps for large specimen extraction and morcellation while performing laparoscopic minimally invasive surgery. We review our port set up and patient positioning. We then show our efficient conversion from a 12mm Hasson port to mini-laparotomy to facilitate placement of a 50x50cm specimen containment bag. Proper bag orientation and specimen placement are demonstrated. Lastly, bag contained hand morcellation is performed for specimen extraction.

Conclusion: This video demonstrates our surgical technique for large specimen extraction during laparoscopic surgery. We review tips and tricks to facilitate safe and efficient bagging and contained hand morcellation.