Retrieval Bag Allows Removal of ESD Specimens From Rectum Without Fragmentation

Retrieval Bag Allows Removal of ESD Specimens From Rectum Without Fragmentation

Douglas K. Rex, MD, MASGE, reviewing Tani Y, et al. Endosc Int Open 2023 May 23.

Very large specimens obtained by endoscopic submucosal dissection may fragment during retrieval through the anus. The Endo Carry Large Type (Hakko Co, Tokyo, Japan) is a modification of Endo Carry, with increased capacity. The new bag is 60 mm in diameter and 40 mm in depth and increased from 3 to 20 ml capacity. 

In this study, 246 consecutive endoscopic resections of colorectal lesions >20 mm, 18 were considered big enough to require removal from the rectum in the bag.

To use the bag, colonic lesions are first maneuvered to the rectum using biopsy forceps. Once the specimen is in the rectum, the endoscope is withdrawn and covered with the open bag, and the bag is advanced into the rectum. The specimen is placed into the bag using biopsy forceps. A drawstring is used to close the bag, which is then withdrawn through the anus. 

Sixteen of the 18 specimens were retrieved without fragmentation. The median lesion size was 62.5 mm, and the median retrieval time was 4 minutes. There were no adverse events.

Douglas K. Rex, MD, FASGE


This large retrieval bag appears to be one solution to the problem of retrieving very large ESD specimens through the anus without fragmentation.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.


Tani Y, Takeuchi Y, Asada Y, et al. Potential role of a novel endoscopic retrieval bag for large colorectal resected specimen: a proof-of-concept study. Endosc Int Open 2023 May 23. (Epub ahead of print) (

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