Abstract:
An improved retractable cleat device having a housing and a telescopic cleat member absent a handle. The telescopic cleat member is lockable in the housing in a retracted position via a cam channel having at least one interval engaging a cam follower. The cam channel includes at least one interval which unlocks the telescopic cleat and allows the telescopic cleat to move to an upraised position via a bias force of a compression spring.

Description:
This application claims the benefit of priority of U.S. Provisional Application Serial No. 60/081,609 filed Apr. 13, 1998. 
    
    
     BACKGROUND OF THE INVENTION 
     1. Field of the Invention 
     The present invention relates to laparoscopic instruments and, more particularly, to laparoscopic specimen removal apparatuses. 
     2. General Background 
     One of the biggest concerns in laparoscopic surgery is the number of laparoscopic instruments required to perform the surgical procedure and thus the number of incisions in the patient to insert such instruments. Therefore, several attempts have been made to integrate the functions of different laparoscopic instruments in such a manner that the number of incisions or trocar sites required to carry out the surgical procedure is minimized. However, any such integration of functions should not complicate the overall surgical procedure but instead simplify. 
     Before extracting the tissue or specimen from the patient&#39;s cavity, the tissue/specimen is placed in a receptacle such as, a bag, web or sheath to minimize further exposure of the other organs from the possibly diseased tissue/specimen being removed. As can be surmised, the bag or receptacle must be opened and/or deployed and, preferably, closed while in the patient cavity. 
     Several laparoscopic instruments have been patented which are used to assist in tissue removal during laparoscopic surgery. 
     U.S. Pat. No. 5,630,822, issued to Hermann et al., discloses a laparoscopic tissue removal device which includes a grasper coaxially mounted within an expandable sheath and including jaws for grabbing a specimen. However, a second tool must be used to tie off the sheath. Additionally, the use of other conventional laparoscopic grasping tools to push the mass into the flared end of the sheath is disclosed. 
     U.S. Pat. Nos. 5,190,555, issued to Wetter et al.; 5,336,227, issued to Nakao et al.; and, 5,352,184, issued to Goldberg et al. all disclose laparoscopic tools with a bag for capturing tissue, closing the bag via a drawstring and withdrawing it back through the tool. 
     U.S. Pat. Nos. 5,496,330, issued to Bates; 5,658,296, issued to Bates et al.; and, 5,197,968, issued to Clement all disclose a laparoscopic tools where the tool has a flexible basket for the tissue capture. 
     U.S. Pat. Nos. 5,176,687, issued to Hasson et al. and 5,312,417, issued to Wilk disclose laparoscopic tools with an open ended bag to capture tissue samples. In the Hasson et al. patent (&#39;687), though a laparoscopic removal tool can be inserted through the bag, the bag must be pulled down out of a sleeve and opened with the assistance of a second tool, such as, forceps. The bag in &#39;687 is made of a membrane which is not rigid and has no rigid supports to allow it to open on its own inside a patient. In the Wilk patent (&#39;417), the receiver portion or open ended web (bag) is provided with support means to open and expand the open ended web (bag). Numerous proposals are suggested to open the receiver portion or web including complicated techniques using hydraulic or pneumatic circuits. Nevertheless, the invention described in &#39;417 does not disclose any means in the laparoscopic cannula assembly which serves to close the open end of the web (bag) and, more specifically, the support means supporting the web (bag). 
     U.S. Pat. Nos. 5,190,1555, 5,336,227, 5,352,184, 5,496,330, 5,312,417, 5,197,968, 5,176,687; 5,630,822, 5,658,296, 5,423,830 are incorporated herein by reference. 
     U.S. Pat. Nos. 5,465,731 and 5,647,372, both of which are assigned to United States Surgical Corporation, disclose a specimen removal pouch and applicator which includes a pouch closed via a drawstring. An additional forceps or grasper inserted though another cannula may be need to unroll the pouch if necessary. The disclosed specimen removal pouch and applicator is not adapted to have a laparoscopic grasper or other laparoscopic instrument inserted coaxially through the applicator. 
     U.S. Pat. No. 5,480,404, issued to Kammerer et al., discloses a surgical tissue retrieval instrument including a collapsible pouch having a cinching mechanism. The instrument of Kammerer et al., like the applicator disclosed in &#39;731 and &#39;372, is not adapted to have a laparoscopic grasper or other laparoscopic instrument inserted coaxially therethrough. 
     U.S. Pat. No. 5,423,830, issued to Schneebaum et al., discloses an instrument assembly having a capture component including a web member attached to spring biased ribs which opens into a cup-shaped configuration when ejected. A vacuum or suction source is provided to provided a negative pressure to assist in clamping the web member and ribs around the tissue/specimen. The instrument assembly of Schneebaum is not adapted to have the cauterization loop inserted coaxially through the web. 
     U.S. Pat. No. 5,074,867, issued to Wilk, discloses a membrane or web having stings or filaments attached to the periphery or corners thereof. Forceps or the like are used to stretch the membrane until it assumes a substantially opened position which is shown as a flat sheet-like profile. The strings are used to surround the membrane or web around the specimen or organ. 
     As can be readily seen, there is a continuing need for a laparoscopic specimen removal apparatus including a laparoscopic specimen extractor having a specimen bag having support means for allowing the bag to be opened and closed without the use of a separate laparoscopic tool; and, a specimen grasper coaxially mountable within the specimen bag. 
     SUMMARY OF THE PRESENT INVENTION 
     The preferred embodiment of the laparoscopic specimen removal apparatus of the present invention solves the aforementioned problems in a straight forward and simple manner. What is provided is an apparatus for removing specimens from a patient during laparoscopic surgery comprising a laparoscopic specimen extractor having a specimen bag having support means for allowing the bag to be opened and closed without the use of a separate laparoscopic tool; and, a specimen grasper coaxially mountable within the specimen bag. 
     Broadly, the laparoscopic specimen extractor comprises:
         (a) a bag having open ends;   (b) a means for supporting said bag having a plurality of tips&#39; wherein said support means is spring biased and uniquely arranged to automatically open into a tulip shape when ejected to a deployed position;   (c) means coupled to said plurality of tips for cinching closed said support means; and   (d) a pathway, formed coaxially through said laparoscopic specimen extractor and said support means and having said cinching closed means journalled axially therethrough wherein said pathway is adapted to have inserted coaxially therethrough a grasping laparoscopic instrument for retrieving said specimen, adapted to have retracted therethrough said grasping laparoscopic instrument to deposit said specimen in said bag and adapted to aspirate or morcelate said specimen in said bag therethrough.       

     The support means cinches closed to a generally elliptical or football shape. 
     In view of the above, it is an object of the present invention to provide a laparoscopic specimen removal apparatus which includes a laparoscopic specimen extractor having a cage lined with a liner or bag which automatically expands and opens to a “tulip” shape when deployed and means secured to the cage for cinching closed distal ends or tips of the cage when opened. 
     Another object of the invention is to provide such a cage or support means with a plurality of spring biased strips having tips wherein a first set of the strip tips are tied together via a first drawstring and a second set of the strip tips are tied togther via a second drawstring. Pulling the first and second drawstrings cinches closed the tips and, thus, the liner or bag attached to the cage. 
     A further object of the present invention is to provide such a cage or support means which when closed the plurality strips are essentially straight, when opened forms a “tulip” shape and when cinched closed forms an “elliptical” or “football” shape. 
     A further object of the present invention is to provide a support means which include rigid but flexible strips which are secured to the bag. 
     It is a still further object of the present invention to provide such a laparoscopic specimen extractor with a cinching closed means including first and second drawstrings and a means for pulling the drawstrings simultaneously to cinch close the cage or support means. 
     It is a still further object of the present invention to provide the cage or support means with a plurality of strips wherein each strip has a free end twisted approximately 90° (ninety degrees) with respect to the rest of the strip to form a twisted section and a hole is bored in such twisted section. This twisted section is substantially perpendicular to the center axis of inner tube assembly and thus the cage. Likewise, the center of the holes in the twisted sections is substantially perpendicular to said center axis. Thereby, as the tips (twisted section) is cinched closed via the drawstring the twisted section are drawing toward each other so that an “elliptical” or “football” shape is created. 
     In view of the above objects, it is a feature of the present invention to provide a laparoscopic specimen extractor which is simple to use and further does not complicate the tissue surgical procedure but instead simplifies it. 
     Another feature of the present invention is to provide a laparoscopic specimen extractor which is relatively simple structurally and thus simple to manufacture. 
     A major advantage of the laparoscopic specimen extractor it its utilization of a unique specimen entrapment system which compresses and forms the specimen into a “dilator” or “football” shaped package in which its cross section&#39;s diameter is much smaller than its length. This aerodynamic shape has the advantage of exiting a smaller incision with significantly less effort than conventional bag type retrieval systems which form the specimen into a “spherical” or basketball” shape which is difficult to pull through a small incision. 
     Another advantage of the present invention is the ability of the laparoscopic specimen extractor, through a single site, to (1) insert a grasping laparoscopic instrument through (coaxially) the extractors&#39; center; (2) retrieve a specimen and pull the specimen into the specimen cage/bag assembly via the coaxially inserted grasping laparoscopic instrument; (3) compress the specimen cage/bag assembly into an aerodynamic package; (4) aspirate and/or morcelate the specimen in a protective environment; and, (5) remove the specimen from the patient&#39;s cavity. 
     The above and other objects, features and advantages of the present invention will become apparent from the drawings, the description given herein, and the appended claims. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWING 
       For a further understanding of the nature and objects of the present invention, reference should be had to the following description taken in conjunction with the accompanying drawings in which like parts are given like reference numerals and, wherein: 
         FIG. 1  illustrates a cross-sectional view of the laparoscopic specimen extractor of the present invention with the cage/bag assembly in the retracted position; 
         FIG. 2  illustrates a cross-sectional view of the laparoscopic specimen removal apparatus of the present invention with the cage/bag assembly in the open deployed position; 
         FIG. 3  illustrates a cross-sectional view of the laparoscopic specimen removal apparatus of the present invention with the cage/bag assembly in the closed position; 
         FIG. 4  illustrates a partial perspective view of the spring loaded strips in an open position; 
         FIG. 5  illustrates a top view of the bag retaining collar; 
         FIG. 6  illustrate a first alternate embodiment of the laparoscopic specimen removal apparatus of the present invention with the cage/bag assembly in the open deployed position; 
         FIG. 7  illustrates the first alternate embodiment of the laparoscopic specimen removal apparatus of the present invention with the cage/bag assembly in the closed position; 
         FIG. 8  illustrates a top view of the drawstring handle assembly of  FIG. 6 ; 
         FIG. 9  illustrates an alternate embodiment of the drawstring handle assembly; 
         FIG. 10  illustrates a perspective view of a second alternate embodiment of the laparoscopic specimen extractor of the present invention with the cage/bag assembly in the deployed position; 
         FIG. 11  illustrates an exploded perspective view of a fourth alternate embodiment of the laparoscopic specimen removal apparatus of the present invention with the cage/bag assembly in the deployed position; 
         FIG. 12  illustrates a perspective view of a fifth alternate embodiment of the laparoscopic specimen removal apparatus of the present invention with the specimen cage/bag assembly closed in the substantially “elliptical” or “football” shape; and, 
         FIG. 13  illustrates the twisted end section of a respective spring loaded strip. 
     
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT 
       FIGS. 2 and 3  illustrates a cross-sectional view of the laparoscopic specimen removal apparatus  100  of the present invention with the cage/bag assembly  15  in the open deployed position. The laparoscopic specimen removal apparatus  100  includes in general laparoscopic specimen extractor  10  and grasping laparoscopic instrument  80 . 
       FIG. 1  is a cross-sectional view showing the laparoscopic specimen extractor  10  with the specimen cage/bag assembly  15  in a retracted position. The laparoscopic specimen extractor apparatus  10  is a laparoscopic device used to facilitate the removal of a specimen  30  from a patient&#39;s cavity through a trocar or trocar site. The laparoscopic specimen extractor  10  basically has a tube inside a tube design. 
     The laparoscopic specimen extractor  10  in general comprises a specimen cage/bag assembly  15 , an outer tube assembly  40 , serving as the container for the specimen cage/bag assembly  15 , and an inner tube assembly  50  which is slidably coupled in the outer tube assembly  40  and has the specimen cage/bag assembly  15  on its patient end. 
     The outer tube assembly  40  is fabricated of surgical-grade stainless steel or any other biocompatible material having a diameter of 10 mm with a wall thickness of approximately 0.25 mm. A collar  60 , made of the same material as the outer tube assembly  40 , is 13 mm in diameter and 10 mm long with a wall thickness of approximately 1.5 mm. The collar  60  is axially fused to the operator end of the outer tube assembly  40 . The collar  60  has a groove approximately 1 mm wide cut into the inner circumference, positioned 1.5 mm from the open end of the collar  60 . Such groove accommodates a 9.5 mm surgical grade O-ring  65  which provides an air-tight seal with the inner tube assembly  50 . 
     A finger ring assembly  70 , made of surgical-grade stainless steel, or any other biocompatible material, is mounted at the collar end or, in other words, the operator end, of the outer tube assembly  40 , surrounding the collar  60 . The finger ring assembly  70  contains two (2) rings  71  oriented across from each other, resembling finger holes of a large syringe. The rings  71  have approximately a 15 mm inner diameter and a 3 mm ring thickness or width and are positioned approximately 20 mm from the collar end of the tube assembly  40  to the ring&#39;s centers. The total length of the outer tube assembly  40  is approximately 200 mm. 
     The inner tube assembly  50  is fabricated of surgical grade stainless seel or any other biocompatible material. The inner tube assembly  50  has an outer diameter of 9.5 mm with a wall thickness of approximately 0.25 mm and a length of 200 mm. The inner tube assembly  50  has external threads (not shown), on the operator end, 8 mm long with an outer diameter of approximately 11 mm. An internally threaded end cap  74 , which has an integrated thumb cradle  72 , is threaded onto the operator end of the inner tube assembly  50 . 
     Referring also to  FIGS. 2 and 3 , a 6 mm hole  75  is bored through the center of the end cap  74 , as best seen in  FIG. 1 , to accommodate the grasping laparoscopic instrument  80 . The grasping laparoscopic instrument  80  is to be coaxially inserted through the center of thumb cradle  72  down through the inner tube assembly  50 . Two (2) small holes  76 , approximately 0.5 mm, are bored into the side of the end cap  74  to allow a passage for two (2) drawstrings  28  and  38  which are tied to ring  29 . A seal (not shown) fabricated of surgical grade silicone or any other medical grade flexible material which has a diameter of 10 mm and a thickness of 0.20 mm with a 5 mm flexible hole in the center aligned with the hole  75  in the end cap  74  is installed between the operator end and the underside surface of the end cap  74 . This seal prevents gas from leaking around the laparoscopic instrument  80  when inserted. A plug (not shown), which is 10 mm long having an outer diameter of 6 mm fabricated of medical grade silicone, is used to plug the hole  75  in the end cap  74  and, when not in use, is tethered from the end cap  74 . This plug prevents gas from leaking from the patient to atmosphere before insertion of extractor  10 . 
     Referring now to  FIGS. 6 and 7 , an alternate embodiment of the laparoscopic specimen removal apparatus  100 ′ is shown. The primary difference is that in lieu of ring  29  and integrating the thumb cradle  72  with end cap  74 , a drawstring handle assembly  90  is substituted. The drawstring handle assembly  90  includes internally threaded end cap  74 ′ which is threaded onto the operator end of inner tube assembly  50  and a rod or handle  91  which is integrated with the end cap  74 ′ to radially project from the outer circumferential surface of end cap  74 ′ at approximately 45° (forty-five degrees). The draw drawstring handle assembly  90  further includes a palm rest  92  affixed to the free end of the rod or handle  91  and a sliding finger squeeze slide  93 . 
     Like end cap  74 , end cap  74 ′ is provided with a bored hole  75 ′, for the insertion of the laparoscopic instrument  80  and the bored side holes  76 ′ (only one shown) for the passage of the two (2) drawstrings  28  and  38 . The free ends of the draw strings  28  and  38  are affixed or tied to the sliding finger squeeze slide  93  slidably mounted on rod or handle  91 . In the exemplary embodiment, when the operator squeezes the fingers on finger squeeze slide  93 , sliding finger squeeze slide  93  slides upward toward palm rest  92  thereby simultaneously pulling drawstrings  28  and  38  to cinch close cage  20 . 
     Referring now to  FIG. 9 , in lieu of the drawstring handle assembly  90 , drawstring hand assembly  90 ′ is substituted. The drawstring handle assembly  90 ′ includes internally threaded end cap  74 ″ which is threaded onto the operator end of inner tube assembly  50  and a rod or handle  91 ′ which is integrated with the end cap  74 ′ to radially project from the outer circumferential surface of end cap  74 ′. The draw drawstring handle assembly  90 ′ further includes a palm rest  92 ′ affixed to the free end of the rod or handle  91 ′ and a sliding finger squeeze slide  93 ′. In this embodiment, palm rest  92 ′ and squeeze slide  93 ′ have an enlarged surface area. Locking means  99  holds slide  93 ′ in the “up” position of  FIG. 12 , by frictional engagement (it binds itself) and attachment to slide  93 ′ and can be released by movement toward slide  93 ′. 
     Like end cap  74 ′, end cap  74 ″ is provided with a bored hole  75 ″, for the insertion of the laparoscopic instrument  80  and the bored side holes  76 ″ for the passage of the two (2) drawstrings  28  and  38 . The free ends of the draw strings  28  and  38  are affixed or tied to the sliding finger squeeze slide  93 ′ slidably mounted on rod or handle  91 ′ via holes  93 a′ and  93 b′. Longitudinal bore holes  93 a′ and  93 b′ are position in close proximity to the outer perimeter edge of squeeze slide  93 ′ so the operator&#39;s fingers can be positioned on the underside of squeeze slide  93 ′ between the drawstrings  28  and  38  and rod or handle  91 ′. 
     Referring now to  FIG. 10 , a perspective view of an alternate embodiment of the laparoscopic specimen extractor  10 ′ is shown. The primary difference between the laparoscopic specimen extractor  10 ′ and the laparoscopic specimen extractor  10  of  FIG. 1  is that the bored side holes  76  of  FIG. 1  for the passage of the two (2) drawstrings  28  and  38  have been moved to a position adjacent the hole  75  formed in the end cap  74 . Thereby, the drawstrings  28  and  38  exit the rear end of the end cap  74  and not through the side. Additionally, the finger rings  71 ′ differ from the finger rings  71  in that finger rings  71 ′ are squared in stead of circular. 
     The squared finger rings  71 ′ are integrated with jacket  79  having a bored hole therethrough. The operator end of the outer tube assembly  40  has affixed thereto jacket  79  such that jacket  79  is stationary. 
     Referring now to  FIGS. 11 and 12 , an alternate embodiment of the laparoscopic specimen removal apparatus  100 ″ is shown. The primary difference is that in lieu of the thumb cradle  72  of  FIG. 10 , the drawstring handle assembly of  FIG. 9  has been substituted. Furthermore, instead of affixing rod or handle  91 ′ 90° (ninety degrees) with respect to the circumferential surface of end cap  74 ″, rod or handle  91 ′ is angled approximately 45° (forty-five degrees).  FIG. 11  illustrates cage/bag assembly  15  of the laparoscopic specimen removal apparatus  100 ″ deployed and in the open position.  FIG. 12  illustrates cage/bag assembly  15  of the laparoscopic specimen removal apparatus  100 ″ deployed and in the cinched closed position. 
     Since the cage/bag assembly  15  of  FIGS. 1-7  and  10 - 12  are essentially the same, the cage/bag assembly  15  shown in  FIGS. 1-4  will be described herein in detail. At the patient end of inner tube assembly  50 , six (6) spring loaded strips  21 ,  22 ,  23 ,  24 ,  25  and  26 , fabricated of medical grad material approximately 120 mm long and 3 mm wide with a thickness of 0.40 mm, are mounted in a circular fashion spaced 60° (sixty degrees) apart to the inner circumference of the inner tube assembly  50 . These spring loaded strips  21 - 26  are recessed approximately 15 mm inside of the inner tube assembly  50  and protrude out of the end of the inner tube assembly  50  approximately 105 mm. The protruding portion of the spring loaded strips  21 - 26  are curved outward approximately 20 mm from the tube&#39;s axis in an arc fashion, when in the retracted position, as best seen in  FIGS. 2 and 4 . The six (6) spring loaded strips  21 - 26  protruding from the inner tube assembly  50  are capable of forming a shape that resembles a “tulip”, as best seen in  FIGS. 2 and 4 , when in a retracted position. This structure forms the specimen cage  20  or support means which supports the specimen liner or bag  32 . Although six (6) strips  21 - 26  are shown, more or fewer strips could be used. 
     Since the spring loaded strips  21 - 26  protrude out of the end of the inner tube assembly  50  approximately 105 mm, the total length of the spring loaded strips  21 - 26  forming the cage  20  or support means ejected from the patient end of outer tube assembly  40  may be varied in accordance with the size of the specimen  30 . Moreover, as the total length of the spring loaded strips is varied, the amount of expansion or flaring of these spring biased strips  21 - 26  is varied proportionally. 
     Referring also to  FIG. 13 , since each of the spring loaded strips  21 - 26  are essentially identical, only one such strip will be described in detail. On the unattached end, tip or free end of spring loaded strip  21 , 7 mm of said unattached end is twisted at 90° (ninety degrees) with respect to the rest of the strip  21  thus forming a twisted end section  21 a. A 0.5 mm hole  27  is bored in this twisted end section  21 a 1.5 mm from the distal end thereof. The hole  27  accommodates one of two (2) drawstrings  28  and  38 . This twisted section  21 a is substantially perpendicular to the center axis of inner tube assembly  50  and thus the cage  20 . Likewise, the center of the hole  27  in the twisted section  21 a is substantially perpendicular to said center axis. Thereby, as the tips (twisted section  21 a) is cinched closed via the drawstrings  28  and  38 . The twisted sections of all the spring loaded strips  21 - 26  are drawn toward each other so that they are closely circumferentially stacked closely one after the other. Thereby, an “elliptical” or “football” shape is created. Moreover, holes  27  in each of the twisted sections provide a circumferential passageway for drawstrings  28  and  38  wherein the center of the circumferential passageway is perpendicular to the center axis of cage  20  and inner tube assembly  50 . 
     Referring also to  FIG. 5 , the spring loaded strips  21 - 26  are held in place with an internal retaining collar  33  with an outer diameter of approximately 7.5 mm, a length of 15 mm and a 5 mm axially bored hole through the center to allow for the passage of laparoscopic instruments, such as, grasping laparoscopic instrument  80 , therethrough. Also, two (2) holes  34  approximately 0.15 mm in diameter are bored to accommodate the two (2) drawstrings  28  and  38 , respectively, therethrough. The collar  33  is fabricated from a medical grade stainless steel or any other biocompatible material and is positioned approximately 7 mm from the patient end of the inner tube assembly  50 . The spring loaded strips are numbered in a clockwise manner  21 ,  22 ,  23 ,  24 ,  25  and  26  with  21  being adjacent  26 . 
     The drawstring  28 , which is 400 mm long and made of #0 silk suture or any biocompatible ligature, is tied with an appropriate knot through the hole  27  of strip  21 ; the other end is passed or threaded through the hole  27  in the strips  22 ,  23  and  24  making a 90° (ninety degree) turn running parallel along the top of strip  24 , through one of the holes  34  in the retaining collar  33 , through the center of the inner tube assembly  50 , and exiting through one of the holes  76  or  76 ′ in the end cap  74  or  74 ′. The end of drawstring  28  is tied off to a ring  29  or any approximate handle assembly  90  or  90 ′, in the manner as described above. When the drawstring  28  is pulled, strips  21 ,  22 ,  23  and  24  will be drawn together. More specifically, the ends or tips of spring loaded strips  21 - 24  are drawn together. 
     A second drawstring  38 , which is 400 mm long and, likewise, made of #0 silk suture or any biocompatible ligature, is tied with an appropriate knot through the hole  27  of strip  24 ; the other end is passed through the hole  27  in strips  25 ,  26  and  21  making a 90° (ninety degree) turn running parallel along the top of the strip  21 , through the other one of holes  34  in the retaining collar  33 , through the center of the inner tube assembly  50 , exiting through the other one of holes  76  or  76 ′ in the end cap  74  or  74 ′. The end of drawstring  38  is tied off to the same ring  29  or any appropriate handle assembly  90  or  90 ′, as is the other drawstring  28 . When the drawstring  38  is pulled, the strips  24 ,  25 ,  26  and  21  will be drawn togther. More specifically, the ends or tips of spring loaded strips  21  and  24 - 26  are drawn together. 
     When both drawstrings  28  and  38  are pulled simultaneously all the ends or tips of the six (6) spring loaded strips  21 - 26  will be drawn together, thus forming a substantially “elliptically” or “football” shaped cage  20  or support means, as best seen in  FIG. 3 , trapping the specimen  30  inside. As the ends or tips of the spring loaded strips  21 - 26  are drawn together the cage  20  or support means forms a “dilator” or “football” shaped package in which its cross section&#39;s diameter is much smaller than its length. This aerodynamic shape has the advantage of exiting a smaller incision with significantly less effort than conventional bag type retrieval systems which form the specimen into a “spherical” or “basketball” shape which is difficult to pull through a small incision. 
     A cylindrical liner or bag  32  made of surgical grade plastic, such as the material found in U.S. Surgical&#39;s Endo Catch, would be suitable for this application and is positioned inside the spring loaded strips  21 - 26  and hemmed around the drawstrings  28  and  38  and the strip ends or tips. The other end of the cylindrical liner or bag  32  is secured to the inner circumferential wall of the patient end of the inner tube assembly  50  and is held in place by a medical grade bag retaining ring  35 . The bag retaining ring  35 , having an opening of 6 mm, is positioned in front of the internal retaining collar  33 . This liner or bag  32  prevents leakage of specimen fluids during extraction. 
     All of the above individual measurements and dimensions could be reduced by 99.999% or enlarged by 10,000% to fit a specific application. 
     The laparoscopic specimen extractor  10  is assembled by inserting the inner rube assembly  50  inside the outer tube assembly  40  through the operator end. 
     The inner tube assembly  50  has two (2) positions, retracted ( FIG. 1 ) and deployed (FIG.  2 ). In the deployed position, preferably, the patient end of the inner tube assembly  50  is even with the patient end of the outer tube assembly  40 , allowing the specimen cage/bag assembly  15  protruding from the patient end of inner tube assembly  50  to be exposed and opened, as best seen in FIG.  2 . In the retracted position, the inner tube assembly  50  is pulled back approximately 105 mm, causing the cage  20  or support means and the liner  32  to collapse and be contained within outer tube assembly  40 , as best seen in FIG.  1 . 
     The operation of the laparoscopic specimen extraction  10  of the laparoscopic specimen removal apparatus  100  is described below. The laparoscopic specimen extractor  10  is inserted, patient-end first, into a trocar or open incision in the retracted position, as best seen in FIG.  1 . The laparoscopic specimen extractor  10  is then deployed by inserting two (2) fingers in the finger rings  71  on the outer tube assembly  40  and placing the thumb in the thumb cradle  72  on the end cap  74 . The operator slowly squeezes his thumb and fingers together, pushing the inner tube assembly  50  in the outer tube assembly  40  until the specimen cage/bag assembly  15  is fully exposed, as best seen in FIG.  2 . 
     The operator then removes said plug (not shown) in end cap  74  of the inner tube assembly  50  and inserts the grasping instrument  80  through the hole  75 , through the center of the inner tube assembly  50  and the specimen cage/bag assembly  15 , and grasps the specimen  30 , as best seen in FIG.  2 . The operator then pulls the specimen  30  into the cage/bag assembly  15 , as far as possible, by retracting grasping laparoscopic instrument  80 , as best seen in FIG.  3 . After the specimen  30  is placed in the cage/bag assembly  15 , the operator pulls the drawstrings  28  and  38  via ring  29  causing the end or tips of the specimen cage  20  or support means and, thus, liner  32  to be cinched closed, trapping the specimen  30  inside. After the specimen  30  has been placed in the cage/bag assembly  15 , the grasping laparoscopic instrument  80  should be manipulated to release or deposit the specimen  30  in the cage/bag assembly  15  before fully retracting the grasping laparoscopic instrument  80 . 
     The grasping instrument  80  can then be removed from the inner tube assembly  50  by fully retracting the grasping instrument  80  from the inner tube assembly  50  and an aspirator or morcelator may be inserted to remove tissue and fluids to further reduce the size of the specimen  30 . The operator then extracts the laparoscopic specimen extractor  10  through the trocar or open site. 
     From the forgoing, it can be readily seen that an advantage of the laparoscopic specimen extractor  10  is its ability, through a single site, to (1) insert a grasping laparoscopic instrument  80  through (coaxially) the extractors&#39; center; (2) retrieve a specimen  30  and pull the specimen  30  into the specimen cage/bag assembly  15  via the coaxially inserted grasping laparoscopic instrument  80 ; (3) compress the specimen cage/bag assembly  15  into an aerodynamic package; (4) aspirate and/or morcelate the specimen  30  in a protective environment; and, (5) remove the specimen  30  from the patient&#39;s cavity. 
     Referring now to the operation of the embodiment shown in  FIGS. 6 and 7 , in lieu of squeezing the thumb cradle  72  and finger rings  71  together to deploy the laparoscopic specimen extractor  10 , the handle assembly  90  and finger rings  71 ′ of the laparoscopic specimen extractor  10 ′ are squeezed together. For example, the thumb may be placed over the end cap  74 ′ and the fingers in the finger rings  71 ′. Thereafter, the operator slowly squeezes the thumb on the end cap  74 ′ and the fingers in the finger rings  71 ′ together. 
     The operation of the laparoscopic specimen extraction the laparoscopic specimen removal apparatus  100 ′ ( FIG. 10 ) and  100 ″ ( FIGS. 11-12 ) is essentially the same as that which has bee described above with respect to  FIGS. 1-7 . 
     Because many varying and differing embodiments may be made within the scope of the inventive concept herein taught and because many modifications may be made in the embodiment herein detailed in accordance with the descriptive requirement of the law, it is to be understood that the details herein are to be interpreted as illustrative and not in a limiting sense.