Patent Publication Number: US-11660114-B2

Title: Tissue containment systems and related methods

Description:
CROSS REFERENCE TO RELATED APPLICATION 
     This application is a continuation of and claims priority under 35 U.S.C. § 120 to U.S. patent application Ser. No. 15/937,911, filed on Mar. 28, 2018, which claims priority to U.S. Provisional Patent Application No. 62/511,007, filed on May 25, 2017. The entire contents of each of these priority applications are incorporated herein by reference. 
    
    
     TECHNICAL FIELD 
     This disclosure relates to tissue containment systems, related methods, and more particularly to containing tissue morcellated within a body cavity. 
     BACKGROUND 
     Laparoscopic surgery is a type of minimally invasive surgery in which procedures may be performed through small openings (e.g., incisions) in an abdominal wall. In many cases, such procedures involve removal of tissues that are suspected of being pathological. In order to remove a tissue mass that is larger than a size of an incision in the abdominal wall, the tissue mass may be reduced in size (e.g., ground up) by a morcellator that has been introduced into the abdominal cavity and withdrawn (e.g., suctioned) from the abdominal cavity through the morcellator. The morcellation process can undesirably spread (e.g., eject) trace amounts of ground tissue within the abdominal cavity, which can unintentionally upstage a disease state in cases where the tissue mass proves to be malignant or otherwise progressive. Therefore, it can be beneficial to contain and isolate morcellated or otherwise reduced tissue from the abdominal cavity during a tissue reduction process carried out within the abdominal cavity. 
     SUMMARY 
     This disclosure relates to tissue containment systems and methods of using the tissue containment systems during surgical procedures (e.g., laparoscopic procedures). Such tissue containment systems include a containment bag that has a single opening, while having multiple access ports that may be used for procedural steps, such as introducing a tissue removal device (e.g., a morcellator) into the containment bag, manipulating tissue within the containment bag, and visualizing tissue within the containment bag. 
     In one aspect, a tissue containment system includes a containment bag configured to be placed in an abdominal cavity of a patient. The containment bag defines a main portion sized to contain a loose tissue specimen within the abdominal cavity, a first portion providing an opening sized to receive the loose tissue specimen and arranged to extend from the main portion outside of the patient while the main portion is disposed within the abdominal cavity, and a second portion arranged to extend from the main portion outside of the patient while the main portion is disposed within the abdominal cavity, the second portion being configured to receive a tissue visualization device. The tissue containment system further includes a viewing window sealed to the second portion, the viewing window being configured such that the tissue visualization device can view an interior region of the containment bag when the tissue visualization device is disposed in the second portion of the containment bag. 
     Embodiments may include one or more of the following features. 
     In some embodiments, the main portion, the first portion, and the second portion are in fluid communication with one another. 
     In certain embodiments, the main portion and the first portion are in fluid communication with each other and fluidly isolated from the second portion. 
     In some embodiments, the tissue containment system further includes a retainer attached to an external surface of the second portion. 
     In certain embodiments, the retainer is adjustable from a first extent that is smaller than a wound within a wall of the abdominal cavity for passage through the wound to a second extent that is larger than the wound for retaining an end of the second portion outside of the patient. 
     In some embodiments, a wall of the containment bag is configured to thermally isolate the interior region of the containment bag from the abdominal cavity. 
     In certain embodiments, the second portion is formed as a sleeve sized to surround the tissue visualization device. 
     In some embodiments, the second portion is invertible to provide a double wall layer around the tissue visualization device. 
     In certain embodiments, the viewing window is adjustable from a first position outside of the patient to a second position within the abdominal cavity while the main portion of the containment bag is disposed within the abdominal cavity. 
     In some embodiments, an end of the second portion is positionable outside of the patient while the main portion of the containment bag is disposed within the abdominal cavity. 
     In certain embodiments, the viewing window is positioned along a wall of the main portion of the containment bag. 
     In some embodiments, the second portion defines an opening that is positionable outside of the patient while the main portion of the containment bag is disposed within the abdominal cavity. 
     In certain embodiments, the second portion and the viewing window together isolate the tissue visualization device from the loose tissue specimen and from the abdominal cavity. 
     In some embodiments, the tissue containment system further includes an access cap configured to close the opening of the first portion, the access cap including an entry port through which a tissue removal device can be passed to access an interior region of the containment bag. 
     In certain embodiments, the tissue containment system further includes a wound liner that is configured to surround the first portion of the containment bag. 
     In some embodiments, the access cap is configured to be secured to the wound liner in an airtight manner. 
     In certain embodiments, the tissue containment system further includes a bag introducer configured to introduce the containment bag into the abdominal cavity. 
     In some embodiments, the entry port for the tissue removal device provides a passageway for the bag introducer. 
     In certain embodiments, the tissue removal device is a morcellator. 
     In some embodiments, the tissue visualization device is an endoscope. 
     In some embodiments, the containment bag has a general shape of a kidney. 
     In certain embodiments, the first and second portions project from opposite sides of the main portion of the containment bag. 
     In some embodiments, the closed end of the second portion is a sealed end. 
     In certain embodiments, the first portion of the containment bag is an open-ended portion. 
     In some embodiments, the second portion of the containment bag is a closed-ended portion. 
     In certain embodiments, the tissue removal device is a tissue reduction device. 
     In another aspect, a method of containing a loose tissue specimen within an abdominal cavity of a patient includes introducing a containment bag into the abdominal cavity, moving a loose tissue specimen within the abdominal cavity into a main portion of the containment bag through an opening of a first portion of the containment bag, positioning the first portion of the containment bag outside of the patient while the main portion is disposed within the abdominal cavity, positioning a second portion of the containment bag outside of the patient while the main portion is disposed within the abdominal cavity, and inserting a tissue visualization device into the second portion to view an interior region of the containment bag with the tissue visualization device through a viewing window that provides a seal between an ambient environment and the interior region of the containment bag. 
     Embodiments may include one or more of the following features. 
     In some embodiments, the method further includes inflating the containment bag. 
     In certain embodiments, the method further includes thermally isolating the interior region of the containment bag from the abdominal cavity. 
     In some embodiments, positioning the second portion outside of the patient includes pulling a retainer ring attached to an external surface of the second portion through a wound in wall of the abdominal cavity. 
     In certain embodiments, the retainer is adjustable from a first extent that is smaller than the wound to a second extent that is larger than the wound. 
     In some embodiments, the method further includes retaining the second portion outside of the patient. 
     In certain embodiments, the method further includes inserting the tissue visualization device into a sleeve that forms the second portion. 
     In some embodiments, the method further includes inverting the sleeve to provide a double wall layer around the tissue visualization device. 
     In certain embodiments, the method further includes adjusting the viewing window from a first position outside of the patient to a second position within the abdominal cavity while the main portion of the containment bag is disposed within the abdominal cavity. 
     In some embodiments, the method further includes positioning an end of the second portion outside of the patient while the main portion of the containment bag is disposed within the abdominal cavity. 
     In certain embodiments, the viewing window is positioned along a wall of the main portion of the containment bag. 
     In some embodiments, the method further includes positioning an opening of the second portion outside of the patient while the main portion of the containment bag is disposed within the abdominal cavity. 
     In certain embodiments, the method further includes isolating the tissue visualization device from the loose tissue specimen and from the abdominal cavity. 
     In some embodiments, the method further includes closing the opening of the first portion with an access cap that includes an entry port for the tissue removal device. 
     In certain embodiments, the method further includes inserting a wound liner into a wound within a wall of the abdominal cavity and passing the first portion of the containment bag through the wound liner. 
     In some embodiments, the method further includes securing the access cap to the wound liner in an airtight manner. 
     In some embodiments, the method further includes passing a bag introducer through the entry port of the access cap. 
     In certain embodiments, the method further includes introducing the containment bag into the abdominal cavity. 
     In some embodiments, the method further includes morcellating the tissue contained within the main portion of the containment bag. 
     In certain embodiments, the method further includes viewing the interior region of the containment bag with an endoscope. 
     In some embodiments, the surgical procedure is a laparoscopic procedure. 
     In another aspect, a tissue containment system includes a bag body that at least partially defines an interior region configured to contain a loose tissue specimen and that defines an opening sized to receive the loose tissue specimen, the bag body being configured such that a first portion of the bag body can be disposed in an abdominal cavity of a patient while a second portion of the bag body extends outside of the patient. The tissue containment system further includes a member extending from the bag body and defining a channel and a viewing window that is at least partially transparent and that provides a seal between the interior region of the bag body and an ambient environment, the channel of the member being configured to receive a tissue visualization device that can be used to view the interior region of the containment bag through the viewing window. 
     In some embodiments, the bag body and the member are in fluid communication with each other. 
     In certain embodiments, the bag body and the member are fluidly isolated from each other. 
     In some embodiments, the tissue containment system further includes a retainer attached to an external surface of the member. 
     In some embodiments, the retainer is adjustable from a first extent that is smaller than a wound within a wall of the abdominal cavity for passage through the wound to a second extent that is larger than the wound for retaining the member outside of the patient. 
     In certain embodiments, wherein a wall of the bag body is configured to thermally isolate the interior region of the bag body from the abdominal cavity. 
     In some embodiments, the member is formed as a sleeve sized to surround the tissue visualization device. 
     In certain embodiments, the member is invertible to provide a double wall layer around the tissue visualization device. 
     In some embodiments, the viewing window is adjustable from a first position outside of the patient to a second position within the abdominal cavity while the first portion of the bag body is disposed within the abdominal cavity. 
     In some embodiments, an end of the member is positionable outside of the patient while the first portion of the bag body is disposed within the abdominal cavity. 
     In certain embodiments, the viewing window is positioned along a wall of the first portion of the bag body. 
     In some embodiments, the member defines an opening that is positionable outside of the patient while the first portion of the bag body is disposed within the abdominal cavity. 
     In certain embodiments, the member and the viewing window together isolate the tissue visualization device from the loose tissue specimen and from the abdominal cavity. 
     In some embodiments, the tissue containment system further includes an access cap configured to close the opening of the bag body, the access cap including an entry port through which a tissue removal device can be passed to access the interior region of the bag body. 
     In certain embodiments, the tissue containment system further includes a wound liner that is configured to surround the second portion of the bag body. 
     In some embodiments, the access cap is configured to be secured to the wound liner in an airtight manner. 
     In certain embodiments, the tissue containment system further includes a bag introducer configured to introduce the bag body into the abdominal cavity. 
     In some embodiments, the entry port for the tissue removal device provides a passageway for the bag introducer. 
     In certain embodiments, the tissue removal device is a morcellator. 
     In some embodiments, the tissue visualization device is an endoscope. 
     In another aspect, a tissue containment system includes a containment bag configured to be placed in an abdominal cavity of a patient. The containment bag defines a main portion sized to contain a loose tissue specimen within the abdominal cavity, a first portion providing an opening sized to receive the loose tissue specimen and arranged to extend from the main portion outside of the patient while the main portion is disposed within the abdominal cavity, and a second portion arranged to extend from the main portion outside of the patient while the main portion is disposed within the abdominal cavity and providing a sealable end configured to receive a tissue visualization device at a location outside of the patient. The tissue containment system further includes a sealable connector attached to the sealable end of the second portion and through which the tissue visualization device can be passed to view an interior region of the containment bag. 
     Embodiments may provide one or more of the following advantages. 
     In some embodiments, the containment bag defines a main portion sized to hold and surround the tissue, an open-ended portion by which the main portion can be accessed with surgical instruments, and a closed-ended portion by which an interior region of the specimen container can be viewed with a tissue visualization device. The open-ended portion can provide a single opening (i.e., the only opening) of the containment bag. 
     In certain embodiments, the closed-ended portion has a preformed shape (e.g., a tubular shape) that projects from the main portion to facilitate positioning of the closed-ended portion within the wound. The closed-ended portion also defines a position of the viewing window along the containment bag such that contact between the viewing window and a tissue visualization device provides a tactile indication of an orientation and a position of the containment bag within the abdominal cavity. Because the closed-ended portion is sized and shaped to extend through the wound outside of the patient, the closed-ended portion can accommodate an inverted placement of the viewing window within the interior region of the containment bag. 
     In some embodiments, the viewing window has an unobstructed wall (e.g., without interior seam lines) that is impenetrable to engaging laparoscopic devices. The viewing window also provides the tissue containment system with an access port (e.g., a vision access port) that is separate from the access cap such that a region in which a tissue visualization device (e.g., an endoscope or laparoscope) is placed is out of the way of a region that may contain other surgical tools. The viewing window provides an optically clear barrier between the tissue visualization device and the interior of the containment bag. For example, the inner end region of the viewing window may be the only portion of the tissue containment system that separates a distal end of the tissue visualization device from the interior region of the containment bag. Accordingly, fogging of the tissue visualization device that may otherwise occur as a result of exposure to an interior region of the containment bag is prevented or minimized. 
     In certain embodiments, the retainer ring serves to fix a position of the closed-ended portion within a wound within the abdominal wall. The retainer ring is a compressible structure that can be compressed to pass through the wound and that can expand to a nominal configuration upon removal of an applied compression force to retain the closed-ended portion outside of the patient. Accordingly, the retainer ring locates the closed-ended portion of the containment bag with respect to the wound such that the viewing window extends from the abdominal wall for easy access by a tissue visualization device. The retainer ring may also be compressed in a packaging configuration within a bag introducer. 
     In some embodiments, the tissue visualization device remains isolated from the abdominal cavity when the tissue visualization device is inserted within the viewing window and moved down into the abdominal cavity. Inserted through the wound, the tissue visualization device has significant, improved  3 D mobility to view the abdominal cavity, as compared to use with conventional containment bags that require use of a tissue visualization device with a trocar to maintain insufflation, but which also limits the degrees of freedom of the tissue visualization device. Because the tissue visualization device is withdrawn through the inverted configuration of the closed-ended portion of the containment bag, the tissue visualization device is isolated from the abdominal cavity and from the abdominal wall and thereby prevented from potentially contaminating the abdominal cavity. Additionally, since the viewing window provides a closed port of the containment bag, the containment bag does not have a second opening that would otherwise require an additional procedural step of closing such an opening to seal the containment bag. Therefore, the configuration of the viewing window reduces the risk of exposing a patient to a contaminated opening. 
     In some embodiments, the containment bag provides a degree of thermal insulation for the interior region of the containment bag within the abdominal cavity, such that the containment bag can be inflated with a gas that has a different temperature (e.g., that is significantly warmer) than a CO 2  insufflation temperature within the abdominal cavity. The isolated, spacious environment of the inflated containment bag increases control of the morcellation environment. For instance, owing to a separation of the interior region of the containment bag from the abdominal cavity, any potential fogging of the tissue visualization device (e.g., in contact with the viewing window) can be prevented or minimized. Additionally, the constituency and warmer temperature of the gas delivered to the containment bag may provide an internal environment of the containment bag that is drier than the environment of the surrounding abdominal cavity, which can aid the start of a desiccation process on the tissue and other wet contents within the containment bag. 
     In certain embodiments, the access cap is constructed to interface with the open-ended region of the containment bag and the wound liner to close the opening of the containment bag outside of the abdominal wall of the patient. The access cap includes a cover plate that is sized to cover the opening of the containment bag. A snap-on configuration of the cover plate that is formed to interface directly with the wound liner provides a relatively simple, easy mechanism for covering the wound. 
     Other aspects, features, and advantages will be apparent from the description, the drawings, and the claims. 
    
    
     
       DESCRIPTION OF DRAWINGS 
         FIG.  1    is an exploded perspective view of a tissue containment system interfaced with an abdomen of a patient. 
         FIG.  2    is an exploded side view of a portion of the tissue containment system of  FIG.  1   . 
         FIG.  3    is a side view of a portion of the tissue containment system of  FIG.  1   , shown with an inverted configuration of a containment bag. 
         FIG.  4    is a perspective view of a wound liner of the tissue containment system of  FIG.  1    and the containment bag, including a viewing window. 
         FIG.  5    is a perspective view of a portion of the tissue containment system of  FIG.  1   . 
         FIG.  6    is a perspective view of an access cap of the tissue containment system of  FIG.  1   . 
         FIG.  7    is a perspective view of a bag introducer of the tissue containment system of  FIG.  1   . 
         FIGS.  8 - 14    illustrate a method of using the tissue containment system of  FIG.  1    during a laparoscopic procedure. 
         FIG.  15    is a perspective view of a tissue containment system interfaced with an abdomen of a patient. 
         FIG.  16    is a perspective view of a tissue containment system interfaced with an abdomen of a patient, with a closeable end in an open configuration. 
         FIG.  17    is a perspective view of the closeable end of the tissue containment system of  FIG.  16    in a closed configuration. 
     
    
    
     DETAILED DESCRIPTION 
       FIGS.  1  and  2    illustrate a tissue containment system  100  (e.g., a morcellation containment system) that can provide an isolated environment in which a tissue  101  that has been separated from a structure within an abdominal cavity  103  of a patient can be morcellated or otherwise reduced and removed during a laparoscopic procedure. Example tissues  101  that may be loosed within the abdominal cavity  103  and morcellated within the tissue containment system  100  include tissues that are suspected of being pathological, but non-malignant, such as uterine fibroids, and endometriotic lesions. In a rare case that a tissue  101  proves to be malignant following the laparoscopic procedure, trace parts of the tissue  101  generated by the morcellation process will have been contained within the tissue containment system  100  and thereby isolated from the abdominal cavity  103 . Example structures within the abdominal cavity  103  from which the tissue  101  may be separated include organs (e.g., a uterus or an ovary) and other structures. The tissue  101  may be separated from the abdominal structure or some other structure within the abdominal cavity by severance (e.g., cutting), ablation, or other energy sources (e.g., laser sources, electrocautery sources, harmonic sources, and bimodal energy sources). The tissue containment system  100  is constructed to interface with an abdominal wall  105  of the patient and is a disposable system that is discarded upon completion of the laparoscopic procedure. 
     The tissue containment system  100  includes a specimen container  102  that can be placed within the abdominal cavity  103 , an access cap  104  formed to close the specimen container  102  along an external surface of the abdominal wall  105 , a wound liner  106  (e.g., a wound protector) by which a portion of the specimen container  102  can be passed through a wound  107  (e.g., an incision) in the abdominal wall  105 , and a bag introducer  110  by which the specimen container  102  can be placed within the abdominal cavity  103 . The various components of the tissue containment system  100  may be provided as a kit of separate components that can be interfaced with each other and with the patient at the time of performing the laparoscopic procedure. 
     Referring to  FIGS.  3  and  4   , the specimen container  102  is generally shaped like a kidney and includes a containment bag  112 , a viewing window  114 , a retainer ring  108 , a drawstring tether  116 , and a pull tether  118 . The containment bag  112  defines a main portion  120  (e.g., a central, largest volumetric portion) sized to hold and surround the tissue  101 , an open-ended portion  122  by which the main portion  120  can be accessed with surgical instruments, and a closed-ended portion  124  by which an interior region of the specimen container  102  can be viewed with a tissue visualization device (e.g., an endoscope or a disposable visualization device). The main portion  120 , the open-ended portion  122 , and the closed-ended portion  124  are in fluid communication with one another. The open-ended portion  122  provides a single opening (i.e., the sole opening)  26  of the specimen container  102 . The open-ended portion  122  is sized and shaped to receive the tissue  101  within the abdominal cavity  103  during one stage of the procedure and to interface with the access cap  104  along the external surface of the abdominal wall  105  during a later stage of the procedure. The opening  126  of the specimen container  102  is lined with the drawstring tether  116 , by which the opening  126  can be closed (e.g., cinched) upon completion of the laparoscopic procedure. The drawstring tether  116  can also be used to pull the open-ended portion  122  up through the wound liner  106  and out of the patient so that a position of the open-ended portion  122  of the containment bag  112  can be fixed between the access cap  104  and the wound liner  106 , as will be discussed in more detail below with respect to  FIGS.  8 - 14   . 
     The retainer ring  108  surrounds the closed-ended portion  124  of the containment bag  112  and serves to fix a position of the closed-ended portion  124  within a wound  109  (e.g., an incision) within the abdominal wall  105 . The retainer ring  108  is a compressible structure that can be compressed to allow it to be passed through the wound  109  and that can expand to a nominal configuration (e.g., as shown in  FIGS.  1 - 5   ) upon removal of an applied compression force. The expanded or nominal configuration of the retainer ring  108  can help to ensure that the retainer ring  108  remains outside the patient during tissue morcellation. 
     The closed-ended portion  124  has a preformed shape that projects from the main portion  120  to facilitate positioning of the closed-ended portion  124  within the wound  109 . The closed-ended portion  124  also defines a position of the viewing window  114  along the containment bag  112  such that contact between the viewing window  114  and a tissue visualization device provides a tactile indication of an orientation and a position of the containment bag  112  within the abdominal cavity  103 . Because the closed-ended portion  124  is sized and shaped to extend through the wound  109  outside of the patient, the closed-ended portion  124  can accommodate an inverted placement of the viewing window  114  within the interior region of the specimen container  102 , as shown in  FIG.  3   . The viewing window  114  is clear, has a U shaped cross-section, and is sized and shaped to receive a distal end of a tissue visualization device directly (e.g., without a trocar) for viewing the interior region of the specimen container  102 . The viewing window  114  is a rigid structure (e.g., as compared to the containment bag  112 ) that has an unobstructed wall (e.g., without interior seam lines) that is impenetrable to engaging laparoscopic devices during normal use. The viewing window  114  provides the tissue containment system  100  with an access port (e.g., a vision access port) that is separate from the access cap  104  such that a region in which a tissue visualization device is placed is out of the way of a region that may contain other surgical tools. The pull tether  118  is attached to the closed-ended portion  124  and can be used to pull the closed-ended portion  124  (e.g., including the retainer ring  108 ) through the wound  109  and outside of the patient. 
     The containment bag  112  is a compliant structure that can be flattened, rolled, and/or folded in a packaging configuration (e.g., within the bag introducer  110 ), inflated to achieve a predetermined, expanded shape (e.g., the general shape of a kidney, as shown in  FIGS.  1 - 4   ) for morcellation of the tissue  101  therein, and allowed to deflate to achieve a less formed, collapsed configuration for removal of the specimen container  102  from the abdominal cavity  103  through the wound liner  106 , as will be discussed in more detail below with respect to  FIGS.  8 - 14   . The containment bag  112  is impermeable to liquids and gases such that once the open end  126  is positioned outside of the abdominal wall  105 , the tissue  101  contained therein is isolated from the abdominal cavity  103  of the patient. The impermeable character of the containment bag  112  further prevents leakage of an inflation gas within the containment bag  112  to the abdominal cavity  103 , as will be discussed in more detail below with respect to  FIGS.  8 - 14   . 
     The containment bag  112  is relatively puncture resistant, such that any potential of the containment bag  112  being pierced by a sharp edge of the morcellator or another laparoscopic device is minimized should the sharp edge inadvertently contact the containment bag  112 . Furthermore, the containment bag  112  defines an interior region that is separated from (e.g., physically and, to some degree, thermally) the abdominal cavity  103 , such that the containment bag  112  can be inflated with a gas (e.g., filtered air) of a temperature that is different (e.g., warmer) than a temperature of CO 2  insufflation gas within the abdominal cavity  103 . For instance, in some examples, the abdominal cavity  103  may be insufflated with medical grade CO 2  at an ambient room temperature in a range of about 19° C. to about 21° C., and the containment bag  112  may be inflated with air at a temperature in a range of about 19° C. up to typical body temperature (e.g., about 37° C.). The containment bag  112  is translucent such that although the containment bag  112  is not optically clear, some light can pass through the containment bag  112 , which may facilitate imaging of the interior region of the containment bag  112 . 
     The containment bag  112  is made of one or more materials that are compliant, impermeable, puncture resistant, and translucent, as described above. Example materials from which the containment bag  112  can be made include polyurethane, ballistic nylon, and ripstop nylon. The containment bag  112  may be formed from one or more sheets of material that are sealed along one or more peripheral edges, excluding the opening  126 . Edges of the one or more sheets of material may be sealed via heat stake, gluing, or ultrasonic attachment. 
     In an inflated state, the containment bag  112  provides a large, safe working zone in which the tissue  101  can be morcellated within the containment bag  112  at a location remote (e.g., spaced apart) from organs in the abdominal cavity  103 . The containment bag  112  is also small enough to avoid significant infolding or double layering of the containment bag  112  within the abdominal cavity  103 . The containment bag  112  can have a volume that is greater than a nominal volume of an abdominal cavity in which it is deployed. For example, an abdominal cavity may have a nominal volume in a range of about 4 L to about 6 L. However, in a fully inflated state (and positioned within a patient, as shown in  FIG.  1   ), the containment bag  112  typically has a volume of about 6 L to about 8 L, and the main portion  120  of the containment bag  112  typically has a volume of about 5.5 L to about 7.5 L. 
     The main portion  120  typically has a nominal (e.g., collapsed, flattened) length of about 30 cm to about 40 cm (e.g., about 35 cm) and a nominal width of about 18 cm to about 24 cm (e.g., about 21 cm). In an inflated state, the open-ended portion  122  is generally cylindrically shaped, and the open end  126  typically has a diameter of about 12 cm to about 24 cm (e.g., about 18 cm). The open-ended portion  122  typically has a nominal length of about 12 cm to about 20 cm (e.g., about 16 cm) and a nominal width of about 12 cm to about 15 cm (e.g., about 14 cm). In an inflated state, the closed-ended portion  124  has a generally tubular shape. The closed-ended portion  124  typically has a nominal length of about 20 cm to about 50 cm (e.g., about 35 cm), an interior (e.g., adjacent the main portion  120 ) nominal width of about 6 cm to about 10 cm (e.g., about 8 cm), and a peripheral nominal width (e.g., adjacent a rim  128  of the viewing window  114 ) of about 1.0 cm to about 1.5 cm (e.g., about 1.2 cm). The closed-ended portion  124  typically extends about 20 cm to about 45 cm outside of the abdominal wall  105  during a laparoscopic procedure. 
     The tethers  116 ,  118  are typically made of one or more materials including nylon, tetrafluoroethylene (TFE), and flashspun high-density polyethylene fibers. The tethers  116 ,  118  typically have a length of about 30 cm to about 50 cm (e.g., about 40 cm). The retainer ring  108  has a nominal internal diameter that is two to four times larger than a length of the wound  109 . For example, the wound  109  typically has a length in a range of about 20 mm to about 25 mm, and the retainer ring  108  typically has a nominal internal diameter of about 3.0 cm to about 3.5 cm (e.g., about 3.0 cm). The retainer ring  108  is attached to the closed-ended portion  124  of the containment bag  112  via heat sealing, glue, or ultrasonic attachment. The retainer ring  108  may be made of one or more soft, expandable or compressible materials that allow the retainer ring  108  to pass through the wound  109 , such as foam, polypropylene, TPE, polyethylene, or santoprene. 
     The viewing window  114  provides an optically clear barrier between the tissue visualization device and the containment bag  112 . The viewing window  114  is attached along the rim  128  to the closed-ended portion  124  of the containment bag  112  in a manner such that an inner end region  130  of the viewing window  114  is free from (e.g., not attached to) the containment bag  112 . Accordingly, the inner end region  130  of the viewing window  114  is the only portion of the tissue containment system  100  that may separate a distal end of the tissue visualization device from the interior region of the containment bag  112 . The viewing window  114  is typically attached to the closed-ended portion  124  of the containment bag  112  via an airtight seal (e.g., a hermetic seal), such as a heat seal, an ultrasonic weld, or one or more mechanical means (e.g., an o-ring, a nut, etc.). In this manner, the viewing window  114  provides a seal between an interior region of the containment bag  112  and an ambient room environment in which the laparoscopic procedure is performed. The viewing window  114  is typically made of one or more clear plastic materials, such as polycarbonate or other optically clear materials. The viewing window  114  typically has a length of about 2.0 cm to about 4.0 cm (e.g., about 3.0 cm) and an internal rim diameter of about 1.0 cm to about 1.5 cm (e.g., about 1.2 cm). 
     Still referring to  FIGS.  3  and  4   , the wound liner  106  provides an extended passageway through the wound  107  and an enlarged exit region near the internal surface of the abdominal wall  105  for the open-ended portion  122  of the containment bag  112  and thereby protects the wound  107  from mechanical wear of the containment bag  112  and potential tissue contamination that may be present thereon near the opening  126  of the containment bag  112 . The wound liner  106  is generally cylindrically shaped and includes a collapsible wall  132  that can be passed though the wound  107 , a port access ring  134  attached to one end of the collapsible wall  132 , and an anchoring ring  136  attached to an opposite end of the collapsible wall  132 . 
     The collapsible wall  132  is a compliant structure that can be collapsed for insertion of the anchoring ring  136  through the wound  107  and that can be extended from the collapsed configuration to position the port access ring  134  against the external surface of the abdominal wall  105  with the anchoring ring  136  positioned within the abdominal cavity  103  (e.g. abutting an internal surface of the abdominal wall  105  or hanging spaced apart from the internal surface of the abdominal wall  105 ). The collapsible wall  132  may have the same material formulation as the containment bag  112  and therefore may be impermeable, puncture resistant, and translucent, as discussed above with respect to the containment bag  112 . The collapsible wall  132  typically has a maximum extended length of about 12 cm to about 16 cm (e.g., about 14 cm) and an internal diameter of about 8 cm to about 12 cm (e.g., about 10 cm). The collapsible wall  132  is typically sealed to itself along its ends snuggly about the port access ring  134  and the anchoring ring  136 . 
     The port access ring  134  may have a rectangular (e.g., square) cross-sectional shape and has a flexibility that allows the port access ring  134  to be snap fit into engagement with the access cap  104 , as will be discussed in more detail below with respect to  FIGS.  8 - 14   . The anchoring ring  136  may have a circular cross-sectional shape and has a flexibility that allows the anchoring ring  136  to be squeezed for inserting through the wound  107 , as will be discussed in more detail below with respect to  FIGS.  8 - 14   . The port access ring  134  and the anchoring ring  136  typically have an internal diameter that is about equal to the internal diameter of the collapsible wall  132 . 
     Referring to  FIGS.  5  and  6   , the access cap  104  is constructed to interface with the open-ended portion  122  of the containment bag  112  and the wound liner  106  to close the opening  126  of the containment bag  112  outside of the abdominal wall  105  of the patient. The access cap  104  includes a cover plate  138  that is sized to cover the opening  126  of the containment bag  112 . The cover plate  138  defines a flat upper wall  156 , a peripheral flange  140  into which the port access ring  134  of the wound liner  106  can be snapped fitted, an insufflation port  142  for connection to a gas line, a morcellation port  144  that allows passage of a morcellator shaft and the bag introducer  110 , and two working ports  146  that allow passage of other laparoscopic tools, such as a dissector, a grasper, an irrigation line, a scope/camera. The access cap  104  further includes valves  148 ,  150  and a quick connect fitting  152  that are respectively secured to the morcellation port  144 , the working ports  146 , and the insufflation port  142 . The valves  148 ,  150  (e.g., cross-slit valves, duck bill valves, or other mechanically activated valves) can secure instruments passing therethrough while allowing passage of only minimal gas leakage out of the containment bag  112 . The quick connect fitting  152  can secure a gas line (e.g., a dual-lumen gas line) that can deliver and/or withdraw gas from the containment bag  112 . For example, such a gas line may include a first lumen that delivers an inflation gas (e.g., medical grade CO 2 ) into the containment bag  112  and a second lumen that withdraws smoke (e.g., produced during power morcellation) out of the containment bag  112 . 
     The cover plate  138  is generally circular and has a diameter that is three to four times larger than a length of the wound  107 . For example, the wound  107  typically has a length in a range of about 20 mm to about 25 mm, and the cover plate  138  typically has a diameter of about 7 cm to about 12 cm (e.g., about 10 cm). The peripheral flange  140  of the cover plate  138  is a lipped structure that forms a receptacle and defines multiple notches  154  that facilitate snap fitting of the port access ring  134  into the peripheral flange  140 . A snap-on configuration of the cover plate  138  that is formed to interface directly with the wound liner  106  provides a relatively simple, easy mechanism for covering the wound  109 , as compared to certain conventional caps. The cover plate  138  may be a rigid, flexible, or semi-rigid structure that is typically made of one or more materials, such as santoprene, EPDM (ethylene propylene diene monomer), polypropylene, nylon, polycarbonate, polyethylene, acrylonitrile butadiene styrene (ABS), polyetherimide (PEI), or other engineering injection medical grade resins. The cover plate  138  may be manufactured using one or more techniques, such as machining or injection molding. The valves  148 ,  150  are typically made of one or more flexible materials, such as silicone. The quick connect fitting  152  is a rigid connection that is typically made of one or more sufficiently rigid materials. 
     Referring to  FIG.  7   , the bag introducer  110  includes a shaft  158  that is sized to accommodate the specimen container  102 , including the containment bag  112  and the viewing window  114  and the retainer ring  108  (omitted from  FIG.  7    for clarity) in a rolled or folded configuration and a slidable button  160  by which the specimen container  102  can be ejected from the shaft  158 . The shaft  158  defines a slot  162  along which the slidable button  160  can be translated distally to move the specimen container  102  and a notch  164  that can receive the slidable button  160  to terminate distal movement of the slidable button  160 . The shaft  158  also defines a distal opening  166  from which the specimen container  102  can exit the shaft  158  as the slidable button  160  is moved distally along the shaft  158 . The bag introducer  110  can be passed through the morcellation port  144  of the access cap  104  for insertion and deployment of the specimen container  102 . The bag introducer  110  typically has a total length of about 15 cm to about 25 cm (e.g., about 20 cm) and an internal diameter of about 2 cm to about 3 cm (e.g., about 2.5 cm). The bag introducer  110  is a rigid structure that is typically made of one or more materials, such as polycarbonate or ABS. 
       FIGS.  8 - 14    illustrate a method of containing (e.g., isolating) the tissue  101  using the tissue containment system  100  during a laparoscopic procedure. Referring to  FIG.  8   , the wound liner  106  is squeezed to a compact configuration and inserted within the wound  107 . The anchoring ring  136  of the wound liner  106  is positioned within the abdominal cavity  103  and allowed to relax to a nominal state. The port access ring  134  of the wound liner  106  remains outside of the abdominal cavity  103  and is allowed to rest against the external surface of the abdominal wall  105  such that an entire extent of the wound  107  is protected by the wound liner  106 . 
     Referring to  FIG.  9   , the access cap  104  is snap fitted to the port access ring  134  of the wound liner  106  to seal the abdominal cavity  103 . A gas line is connected to the quick connect fitting  152  at the insufflation port  142  of the access cap  104 , and the abdominal cavity  103  is insufflated with a gas (e.g., medical grade CO 2 ) delivered from a delivery lumen of the gas line. The CO 2  gas temperature typically has an ambient room temperature of about 19° C. to about 21° C., which is relatively cold as compared to typical body temperature of about 37° C. The insufflation expands a volume of the abdominal cavity  103  to allow the specimen container  102  to be introduced into and deployed within the abdominal cavity  103 . 
     Referring to  FIG.  10   , the gas line is removed, and the bag introducer  110 , loaded with the specimen container  102 , is inserted into the morcellation port  144  of the access cap  104  until at least the distal opening  166  of the shaft  158  is positioned within the wound liner  106 . The slidable button  160  is translated distally until the specimen container  102  is ejected from the shaft  158  and delivered to the abdominal cavity  103 . The bag introducer  110  is removed (e.g., withdrawn) from the morcellation port  144 , and one or more laparoscopic instruments (e.g., a grasper, clamps, or a robotic grasper) are inserted into the abdominal cavity  103  via the working ports  146  of the access cap  104 . 
     Referring to  FIG.  11   , the specimen container  102  is deployed (e.g., the containment bag  112  is unrolled, unfolded, and/or spread out), and the pull tether  118  is pulled through the wound  109  using the laparoscopic instruments. The pull tether  118  may be visualized by an endoscope positioned within a wound of the abdominal cavity  103  during an earlier stage of the surgery. The pull tether  118  is pulled until the retainer ring  108  of the specimen container  102  is positioned outside of the abdominal wall  105 . Accordingly, the retainer ring  108  locates the closed-ended portion  124  of the containment bag  112  with respect to the wound  109  such that the viewing window  114  extends from the abdominal wall  105  for easy access by a tissue visualization device. 
     The tissue visualization device is inserted within the viewing window  114  and is moved down into the abdominal cavity  103  for visualization in a manner such that, due to a position of the retainer ring  108 , the closed-ended portion  124  remains within the wound  109  in an inverted configuration, and the tissue visualization device remains isolated from the abdominal cavity  103 . Inserted through the wound  109 , the tissue visualization device has significant, improved  3 D mobility to view the abdominal cavity  103 , as compared to use with conventional containment bags that require use of a tissue visualization device with a trocar to maintain insufflation. Visualized by the tissue visualization device, the tissue  101  is placed within the containment bag  112  via the opening  126  of the containment bag  112 . The drawstring tether  116  is then pulled into the wound liner  106  using the laparoscopic instruments. With the drawstring tether  116  disposed within the wound liner  106 , the open-ended portion  122  of the containment bag  112  is positioned near the abdominal wall  105  for easy access. The access cap  104  is removed from the wound liner  106 , and the open-ended portion  122  of the containment bag  112  is quickly pulled up through the wound liner  106  until the open-ended portion  122  overlays the port access ring  134  of the wound liner  106 . The open-ended portion  122  is pulled quickly through the wound liner  106  to minimize the loss of pneumoperitoneum (e.g., abdominal gas pressure). 
     Referring to  FIG.  12   , the access cap  104  (e.g., with the gas line still attached to the quick connect fitting  152 ) is quickly reattached to the port access ring  134  (e.g., to minimize the loss of pneumoperitoneum) with the open-ended portion  122  of the containment bag  112  fixed (e.g., sandwiched) between the access cap  104  and the port access ring  134 . The containment bag  112  is inflated (e.g., with filtered air or medical grade CO 2 ) via the delivery lumen of the gas line to make room in the containment bag  112  for insertion of a morcellator (e.g., a power morcellator). For example, the gas exerts forces on an internal surface of the containment bag  112  in a direction normal to the internal surface to expand (e.g., inflate) the containment bag  112  to create a working space needed for a morcellation process. 
     The isolated, spacious environment of the inflated containment bag  112  increases control of the morcellation environment. For instance, owing to heat transfer properties of the material of the containment bag  112 , the temperature of the gas delivered to the containment bag  112  can be about the same (e.g., when the gas is medical grade CO 2 ) or warmer (e.g., when the gas is filtered air) than that of the abdominal insufflation gas such that any potential fogging of the tissue visualization device (e.g., in contact with the viewing window  114 ) is prevented or minimized. The temperature of CO 2  delivered to the containment bag  112  is typically in a range of about 19° C. to about 21° C., whereas the temperature of filtered air delivered to the containment bag  112  is typically in a range of about 19° C. to about 37° C. In some examples, the constituency and warmer temperature of filtered air delivered to the containment bag  112  may provide an internal environment of the containment bag  112  that is drier than the environment of the surrounding abdominal cavity  103 , which can aid the start of a desiccation process on the tissue  101  and other wet contents within the containment bag  112 . Isolating drier filtered air within the containment bag  112  from the abdominal cavity  103  may be advantageous, as peritoneal drying has been linked to post-operative pain and to evaporative cooling, which may decrease core temperature, increase intra-operative hypothermia, and promote adhesion formation. In some examples, the filtered air delivered to the containment bag  112  may be warmer and humidified. To the extent that any heat from filtered air within the containment bag  112  is transferred through the containment bag  112  to the abdominal cavity  103 , such heat will tend to minimize undesirable effects associated with abdominal insufflation CO 2  that is colder than the body temperature. 
     Referring to  FIG.  13   , once the containment bag  112  is inflated, a morcellator  111  is inserted into the containment bag  112  via the morcellation port  144  of the access cap  104  and used to morcellate the tissue  101 . The morcellator  111  may be any suitable, commercially available tissue morcellator. The morcellation process is visualized with the tissue visualization device that is engaged with the viewing window  114  interior to the abdominal cavity  103 , while the tissue visualization device is isolated from the abdominal cavity  103  and isolated from an interior region of the containment bag  112 . During the morcellation process, the tissue  101  is ground into small pieces and withdrawn from the containment bag  112  (e.g., suctioned through the morcellator  111 ). Any trace amounts or particles of tissue generated during the morcellation process, but not suctioned through morcellator  111 , are contained within the containment bag  112  and thus prevented from contacting (e.g., potentially contaminating) the abdominal cavity  103 . 
     Referring to  FIG.  14   , upon completion of the morcellation process, the morcellator  111  is withdrawn from the morcellator port  144 , and any other laparoscopic instruments that may still be disposed within the containment bag  112  are withdrawn from the working ports  146 . After the morcellator  111  and laparoscopic instruments are removed, the tissue visualization device is removed from the wound  109 . Because the tissue visualization device is withdrawn through the inverted configuration of the closed-ended portion  124  of the containment bag  112 , the tissue visualization device is isolated from the abdominal cavity  103  and from the abdominal wall  105  and thereby prevented from potentially contaminating the abdominal cavity  103 . Additionally, since the viewing window  114  provides a closed port of the containment bag  112 , the containment bag  112  does not have a second opening that would otherwise exist in a conventional containment bag and therefore eliminates the need for an additional procedural step to close such an opening and eliminates a potential of exposing a patient to a contaminated opening. Once the tissue visualization device is removed from the patient, the retainer ring  108  is then pushed down into the abdominal cavity  103  through the wound  109 . The access cap  104  is removed from the wound liner  106 , and the open-ended portion  122  of the containment bag  112  is pulled through the wound liner  106  to remove the containment bag  112  from the abdominal cavity  103 . The containment bag  112  can be knotted about itself, tied with the drawstring tether  116 , or otherwise closed at the open-ended portion  122  and discarded. 
     While certain embodiments have been described above, other embodiments are possible. For example, while the tissue containment system  100  has been described and illustrated as including the viewing window  114  disposed along a tip of the closed-ended portion  124  of the containment bag  112 , in some embodiments, a tissue containment system that is otherwise substantially similar in construction and function to the tissue containment system  100  includes a viewing window that is disposed along a main portion of a containment bag. Referring to  FIG.  15   , a tissue containment system  200  includes a specimen container  202  that can be placed within the abdominal cavity  103  and the access cap  104 , the wound liner  106 , and the bag introducer  110  of the tissue containment system  100 . As with the tissue containment system  100 , the various components of the tissue containment system  200  can be provided as a kit of separate components that can be interfaced with each other and with the patient at the time of performing the laparoscopic procedure. 
     The specimen container  202  is shaped similarly to the specimen container  102  and includes a containment bag  212  and a viewing window  214 . The specimen container  202  also includes the retainer ring  108 , the drawstring tether  116 , and the pull tether  118  of the specimen container  102 . The containment bag  212  defines the main portion  120  and the open-ended portion  122  of the containment bag  112  and a closed-ended portion  224  by which an interior region of the specimen container  202  can be viewed with a tissue visualization device. The main portion  120  and the open-ended portion  122  are in fluid communication with each other, but fluidly isolated from the closed-ended portion  224 . The open-ended portion  122  provides a single opening  226  of the specimen container  202  that can be manipulated by the drawstring tether  116 , as discussed above with respect to the specimen containment system  100 . The retainer ring  108  surrounds the closed-ended portion  224  of the containment bag  212  and serves to fix a position of the closed-ended portion  224  within the wound  109  within the abdominal wall  105 . 
     The closed-ended portion  224  is shaped similarly to the closed-ended portion  124  of the containment bag  112  and accordingly projects from the main portion  120  to facilitate positioning of the closed-ended portion  224  within the wound  109 . A sealed interface between the closed-ended portion  224  and the main portion  120  defines a position of the viewing window  214  along the containment bag  212  such that contact between the viewing window  214  and a tissue visualization device provides a tactile indication of an orientation and a position of the containment bag  212  within the abdominal cavity  103 . In this manner, the viewing window  214  further provides a closed end of the closed-ended portion  224  that is arranged to remain inside of the abdominal cavity  103  during morcellation of the tissue  101 . The closed-ended portion  224  defines an opening  268  in a direction opposite the viewing window  214  to provide access to a tissue visualization device. The viewing window  214  is an optically clear, flexible wall that is sized and shaped to be contacted across its area by a distal end of a tissue visualization device for viewing the interior region of the specimen container  202 . The viewing window  214  is stiffer and less compliant than the containment bag  212  and provides an unobstructed wall (e.g., without interior seam lines) that is impenetrable to engaging laparoscopic devices. The viewing window  214  provides the tissue containment system  200  with an access port (e.g., a vision access port) that is separate from the access cap  104  such that a region in which a tissue visualization device is placed is out of the way of a region that may contain other surgical tools. 
     The containment bag  212  has the same material formulation and construction of the containment bag  112  and is therefore compliant, impermeable, relatively puncture resistant, and translucent, as discussed above with respect to the containment bag  112 . The closed-ended portion  224  of the containment bag  212  has the same size and the shape as those of the closed-ended portion  124  of the containment bag  112 . Accordingly, the containment bag  212  provides a large, safe working zone in which the tissue  101  can be morcellated within the containment bag  212  at a location remote (e.g., spaced apart) from organs in the abdominal cavity  103 , while being small enough to avoid significant infolding or double layering of the containment bag  212  within the abdominal cavity  103 . 
     The viewing window  214  provides an optically clear barrier between the tissue visualization device and the containment bag  212 . Accordingly, the viewing window  214  is the only portion of the tissue containment system  200  that may separate a distal end of the tissue visualization device from the interior region of the containment bag  212 . The viewing window  214  is typically attached to the main portion  120  of the containment bag  212  via a heat seal, an ultrasonic weld, or glue. The viewing window  214  is typically made of one or more clear plastic materials, such as polycarbonate or other medical grade clear engineering resins. The viewing window  214  may have a round (e.g., circular) or non-round shape and typically has a total cross-sectional area of about 7 cm 2  to about 10 cm 2  (e.g., about 8 cm 2 ). 
     The tissue containment system  200  can be used similarly to the tissue containment system  100  to contain a tissue during a laparoscopic procedure, as discussed above with respect to  FIGS.  8 - 14   , except that a tissue visualization device is inserted through the opening  268  of the closed-ended portion  224  to access the viewing window  214  instead of being inserted into a viewing window constructed like that of the viewing window  114 . 
     In some embodiments, a tissue containment system that is otherwise substantially similar in construction and function to the tissue containment system  200  may include a containment bag that is closed off (e.g., fluidly isolated) from the closed-ended portion  224 , except that the containment bag is optically clear (e.g., transparent) and does not include a separate viewing window (e.g., the viewing window  214 ). For example, such a containment bag can include an open-ended portion, a closed-ended portion, and a main portion that are similar in construction and function to the respective portions of the containment bag,  212 , except that the bag is optically clear and the main portion does not include the opening defined by the viewing window  214 . In other words, the wall (e.g., sheet material) of the main portion of the containment bag extends across an area to which the closed-ended portion is sealed (e.g., an interior end of the closed-ended portion), such that the containment bag is simply formed as an optically clear (e.g., transparent) bag that defines a single opening (e.g., like the opening  126 ) along one side and that includes a sleeve (e.g., like the closed-ended portion  224 ) extending therefrom along a second side. A tissue containment system including such a containment bag can be used similarly to the tissue containment system  200  to contain a tissue during a laparoscopic procedure. 
     While the tissue containment systems  100 ,  200  have been described and illustrated as including the viewing windows  114 ,  214  that provide closed endoscopic access ports that isolate the tissue visualization device from the interior regions of the containment bags  112 ,  212 , in some embodiments, a tissue containment system that is otherwise substantially similar in construction to either of the tissue containment systems  100 ,  200  includes an open endoscopic access port. For example, as shown in  FIGS.  16  and  17   , a tissue containment system  300  includes a specimen container  302  that can be placed within the abdominal cavity  103  and the access cap  104 , the wound liner  106 , and the bag introducer  110  of the tissue containment system  100 . As with the tissue containment system  100 , the various components of the tissue containment system  300  can be provided as a kit of separate components that can be interfaced with each other and with the patient at the time of performing the laparoscopic procedure. 
     The specimen container  302  is shaped similarly to the specimen container  102  and includes a containment bag  312  and a sealable connector  314  (e.g., a male/female connection mechanism, such as a quick non-spill disconnection). The specimen container  302  also includes the retainer ring  108 , the drawstring tether  116 , and the pull tether  118  of the specimen container  102 . The containment bag  312  includes the main portion  120  and the open-ended portion  122  of the containment bag  112 , and a closeable end portion  324  by which an interior region of the specimen container  302  can be viewed with a tissue visualization device. The main portion  120 , the open-ended portion  122 , and the closeable end portion  324  are in fluid communication with one another. The open-ended portion  122  provides an opening  326  of the specimen container  302  that can be manipulated by the drawstring tether  116 , as discussed above with respect to the specimen containment system  100 . The retainer ring  108  surrounds the closeable end portion  324  of the containment bag  312  and serves to fix a position of the closeable end portion  324  within the wound  109  within the abdominal wall  105 . 
     The closeable end portion  324  is shaped similarly to the closed-ended portion  124  of the containment bag  112  and accordingly projects from the main portion  120  to facilitate positioning of the closeable end portion  324  within the wound  109 . The closeable end portion  324  also defines a position of the sealable connector  314  along the containment bag  312  and a cutting plane  368  located just above (e.g., proximal to) the sealed connector  314  and defining a tip  328  of the closeable end portion  324 . Because the closeable end portion  324  is sized and shaped to extend through the wound  109  outside of the patient, the closeable end portion  324  can accommodate an inverted placement of the sealed connector  314  within the retainer ring  108 . The pull tether  118  is attached to the closeable end portion  324  and can be used to pull the closeable end portion  324  (e.g., including the retainer ring  108 ) through the wound  109  and out of the patient. 
     The sealable connector  314  includes a female connector  370  that is secured to a wall of the closeable end portion  324  and a complementary male connector  372  that is attached to the closeable end portion  324  by a tether  374 . Once the tip  328  of the closeable end portion  324  is cut off, the male connector  372  is accessible and can be removed from the female connector  370 . The female connector  370  is sized to allow passage of a distal end of a tissue visualization device for viewing the interior region of the specimen container  302 . The sealable connector  314  provides the tissue containment system  300  with an access port (e.g., a vision access port) that is separate from the access cap  104  such that a region in which a tissue visualization device is placed is out of the way of a region that may contain other surgical tools. Following visualization of the interior region of the containment bag  312  with the tissue visualization device, the tissue visualization device can be removed from the female connector  370 , and the male connector  372 , still tethered to the containment bag  312 , can be reattached to the female connector  370  to seal the containment bag  312 . 
     The containment bag  312  has the same material formulation and construction of the containment bag  112  and is therefore compliant, impermeable, relatively puncture resistant, and translucent, as discussed above with respect to the containment bag  112 . The closeable end portion  324  of the containment bag  312  generally has the same size and the same shape as those of the closed-ended portion  124  of the containment bag  112 . Accordingly, the containment bag  312  provides a large, safe working zone in which the tissue  101  can be morcellated within the containment bag  312  at a location remote (e.g., spaced apart) from organs in the abdominal cavity  103 , while being small enough to avoid significant infolding or double layering of the containment bag  312  within the abdominal cavity  103 . 
     The sealable connector  314  is typically attached to the closeable end portion  324  of the containment bag  312  via a heat seal, an ultrasonic weld, or one or more mechanical means (e.g., an o-ring, a nut, etc.). The sealable connector  314  is typically made of one or more materials, such as polycarbonate or other materials. The female connector  370  may have an internal diameter of about 0.7 cm to about 1.0 cm (e.g., about 0.8 cm 2 ) to allow passage of a tissue visualization device. 
     The tissue containment system  300  can be used similarly to the tissue containment system  100  to contain a tissue during a laparoscopic procedure, as discussed above with respect to  FIGS.  8 - 14   , except that the tip  328  of the closed-ended portion is cut off and the male connector  372  is removed to allow insertion of a tissue visualization device through the female connector  370  to view the interior region of the containment bag  312  directly instead of viewing the interior region through a viewing window constructed like that of the viewing windows  114 ,  214 . 
     While the tissue containment systems  100 ,  200 ,  300  have been described and illustrated as being used with a tissue morcellator, in some implementations, the tissue containment systems  100 ,  200 ,  300  may be used with another type of tissue removal, reduction, and/or manipulation device, such as a scalpel, an electrosurgical scalpel, or a vacuum (e.g., suction) device. 
     While the containment bags  112 ,  212 ,  312  of the tissue containment systems  100 ,  200 ,  300  have been described as translucent, in some embodiments, a tissue containment system that is otherwise substantially similar in construction and function to any of the tissue containment systems  100 ,  200 ,  300  can include a containment bag that is optically clear (e.g., transparent) to further facilitate imaging of an interior region of the containment bag with a tissue visualization device. 
     While the tissue containment systems  100 ,  200 ,  300  have been described and illustrated as having certain sizes, defining certain volumes, and having certain shapes, in some embodiments, a tissue containment system that is otherwise substantially similar in construction and function to any of the tissue containment systems  100 ,  200 ,  300  can have different sizes, volumes, and/or shapes. In some examples, a tissue containment system can include a containment bag and/or other components that are sized particularly for child patients (e.g., a pediatric tissue containment system), adult patients, patients within a particular age range, or patients with particular medical conditions. 
     Additionally, other embodiments and implementations are within the scope of the following claims.