Patent Publication Number: US-2020289159-A1

Title: Devices, systems, and methods for large tissue specimen removal

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application is a continuation application of U.S. patent application Ser. No. 15/867,888, filed on Jan. 11, 2018, which claims the benefit of U.S. Provisional Patent Application No. 62/448,266, filed on Jan. 19, 2017; U.S. Provisional Patent Application No. 62/461,488, filed on Feb. 21, 2017; and U.S. Provisional Patent Application No. 62/515,622, filed on Jun. 6, 2017. The entire contents of each of these applications is hereby incorporated herein by reference. 
    
    
     BACKGROUND 
     Technical Field 
     The present disclosure relates to tissue specimen removal and, more particularly, to devices, systems, and methods facilitating removal of a large tissue specimen from an internal body cavity, e.g., pelvic cavity. 
     Background of Related Art 
     In minimally-invasive surgical procedures, operations are carried out within an internal body cavity through small entrance openings in the body. The entrance openings may be natural passageways of the body or may be surgically created, for example, by making a small incision into which a cannula is inserted. 
     Minimally-invasive surgical procedures may be used for partial or total removal of tissue from an internal body cavity. However, the restricted access provided by minimally-invasive openings (natural passageways and/or surgically created openings) presents challenges with respect to maneuverability and visualization. The restricted access also presents challenges when large tissue specimens are required to be removed. As such, tissue specimens that are deemed too large for intact removal may be broken down into a plurality of smaller pieces to facilitate removal from the internal body cavity. 
     During such minimally-invasive surgical procedures, it is common that a cyst, tumor, or other affected tissue is required to be removed. In these and other procedures where cancerous tissue is required to be removed, removal of the tissue specimen(s) in an enclosed environment is highly desirable to inhibit seeding of cancer cells. Thus, with respect to breaking down large tissue specimens for removal through minimally-invasive openings, there is the added challenge of doing so within an enclosed environment. 
     SUMMARY 
     As used herein, the term “distal” refers to the portion that is described which is further from a user, while the term “proximal” refers to the portion that is being described which is closer to a user. Further, any or all of the aspects described herein, to the extent consistent, may be used in conjunction with any or all of the other aspects described herein. 
     Provided in accordance with aspects of the present disclosure is a system for removal of a tissue specimen from an internal body cavity. The system includes an access cannula, a deployment cannula, and a containment bag. The access cannula includes a first elongated tubular member and defines a lumen extending through the first elongated tubular member. The deployment cannula includes a second elongated tubular member and a plurality of engagement arms engaged to the second elongated tubular member at fixed ends thereof and extending to free ends thereof. The deployment cannula is configured for slidable positioning within the access cannula and is movable relative there to between an initial condition, wherein the engagement arms are disposed within the lumen of the access cannula and are retained in position adjacent the second elongated tubular member, and a deployed condition, wherein the engagement arms are disposed distally of the lumen and extend radially outwardly from the second elongated tubular member. The containment bag includes a plurality of pockets, each pocket configured to receive one of the engagement arms of the deployment cannula. In the initial condition, a distal end portion of the containment bag is disposed within the lumen of the access cannula between the first and second elongated tubular members. In the deployed condition, the distal end portion of the containment bag is urged distally from the access cannula by the engagement arms and biased towards an open configuration by the engagement arms to present a mouth for receipt of a tissue specimen and/or to urge the mouth about the tissue specimen. 
     In an aspect of the present disclosure, the access cannula includes a proximal hub disposed at a proximal end of the first elongated tubular member. In such aspects, the lumen extends through the proximal hub. 
     In another aspect of the present disclosure, the first elongated tubular member defines a beveled distal end. 
     In another aspect of the present disclosure, the deployment cannula includes a proximal hub disposed at a proximal end of the second elongated tubular member. 
     In yet another aspect of the present disclosure, the deployment cannula defines a second lumen extending through the second elongated tubular member. 
     In still another aspect of the present disclosure, the deployment cannula is configured as a morcellator. 
     In another aspect of the present disclosure, the containment bag includes a reinforced rim at the distal end portion thereof. The reinforced rim may be resiliently flexible, maintained against its bias in the initial condition, and returned under bias in the deployed condition. 
     In yet another aspect of the present disclosure, the containment bag further includes a body portion and a proximal end portion. The body portion is disposed between the proximal and distal end portions. 
     In still another aspect of the present disclosure, the containment bag includes a grasping tab extending from the distal end portion thereof. The distal end portion of the containment bag may be beveled with the grasping tab extending from a protruding portion of the beveled distal end portion. Additionally or alternatively, the grasping tab may define an aperture therethrough. 
     In another aspect of the present disclosure, the containment bag includes a suture arrangement extending from the distal end portion thereof. The suture arrangement, in aspects, may include a plurality of sutures. The first ends of the sutures may be spaced-apart about and attached to the distal end portion of the containment bag. Additionally or alternatively, the second ends of the sutures may be attached to one another. 
     In yet another aspect of the present disclosure, the system further includes a second access cannula configured to receive a grasper therethrough to facilitate positioning of a tissue specimen within the containment bag. 
     In still yet another aspect of the present disclosure, the system includes a third access cannula configured to receive a surgical camera therethrough to provide visualization within an internal body cavity. 
     A method of removing a tissue specimen from an internal body cavity provided in accordance with the present disclosure includes inserting an access cannula through a vagina and into a pelvic cavity, deploying a first end portion of a containment bag from the access cannula into the pelvic cavity while a second end portion of the containment bag remains external of the pelvic cavity or within the access cannula, positioning a tissue specimen within the containment bag through the first end portion of the containment bag, withdrawing the first end portion of the containment bag through an abdominal opening, morcellating the tissue specimen, tying off the second end portion of the containment bag, and withdrawing the containment bag through the abdominal opening such that the second end portion of the containment bag enters the pelvic cavity via the vagina and exits the pelvic cavity through the abdominal opening. The containment bag may alternatively be removed through the vagina in the opposite fashion. 
     In an aspect of the present disclosure, deploying the first end portion of the containment bag includes advancing a deployment cannula through the access cannula to urge the first end portion of the containment bag into the pelvic cavity. 
     In another aspect of the present disclosure, the deployment cannula includes a plurality of engagement arms. The engagement arms are biased outwardly from an elongated tubular member of the deployment cannula such that, upon advancing the deployment cannula through the access cannula, the engagement arms are outwardly expanded under bias to outwardly expand the first end portion of the containment bag within the pelvic cavity. 
     In still another aspect of the present disclosure, the method further includes visualizing at least one of inserting, deploying, positioning, withdrawing, or morcellating through use of a surgical camera inserted through another abdominal opening. The another abdominal opening provides triangulation with the vagina and the abdominal opening. 
     In another aspect of the present disclosure, morcellating the tissue specimen includes pulling an RF loop through the tissue specimen to cut the tissue specimen into smaller strips. A grasper may be used to grasp the tissue specimen to maintain the tissue specimen in position during morcellation of the tissue specimen. 
     In yet another aspect of the present disclosure, positioning the tissue specimen within the containment bag includes inserting a tenaculum through the access cannula and the containment bag, grasping the tissue specimen, and pulling the tissue specimen through the first end portion of the containment bag into the containment bag and/or advancing the containment bag in the opposite direction pushing the containment bag about the tissue specimen. 
     In another aspect, a second stage deployment of the containment bag may be effected where the tissue specimen is located and where morcellation will occur. This can be done by further advancing the containment bag via engagement arms and/or a tube inserted through the access cannula forcing the containment bag further therefrom. 
     In yet another aspect, a line mid-way on the containment bag may be provided to indicate how far to pull the containment bag out of the abdominal opening in order to position it ideally with the least amount of pleating for maximized visualization. 
     In still yet another aspect of the present disclosure, withdrawing the first end portion of the containment bag through the abdominal opening includes inserting a grasper through the abdominal opening, gasping a tab at the first end portion of the containment bag, and pulling the first end portion of the containment bag out through the abdominal opening. As an alternative to a tab, a pull-string and loop may be disposed about the first end portion of the tab for similar purposes. 
     Another system for removal of a tissue specimen from an internal body cavity provided in accordance with aspects of the present disclosure includes a cannula arrangement and a containment bag. The cannula arrangement includes an access cannula, a deployment cannula, a deployment plunger, and an inner cannula. The access cannula includes a first elongated tubular member defining a first lumen extending therethrough. The deployment cannula includes a second elongated tubular member defining a second lumen extending therethrough and is configured for insertion into the first lumen. The second elongated tubular member defines a diameter less than a diameter of the first elongate tubular member such that a first annular spacing is defined between the first and second elongated tubular members when the second elongated tubular member is inserted into the first lumen. The deployment plunger includes a proximal base and a plurality of engagement arms extending distally from the proximal base. The plurality of engagement arms are configured for insertion through the first annular space. The inner cannula includes a third elongated tubular member defining a third lumen extending therethrough and is configured for insertion into the second lumen. The third elongated tubular member defines a diameter less than a diameter of the second elongate tubular member such that a second annular spacing is defined between the second and third elongated tubular members when the third elongated tubular member is inserted into the second lumen. The containment bag is selectively deployable from the cannula arrangement, whereby: distal advancement of the deployment cannula relative to the access cannula deploys a first portion of the containment bag from the cannula arrangement; and distal advancement of the deployment plunger relative to the deployment cannula and the access cannula deploys a second portion of the containment bag from the cannula arrangement. 
     In an aspect of the present disclosure, the first portion of the containment bag is disposed within the first lumen. 
     In another aspect of the present disclosure, the second portion of the containment bag is disposed within the first annular space. 
     In another aspect of the present disclosure, proximal withdrawal and subsequent distal advancement of the inner cannula relative to the deployment cannula and the access cannula deploys a third portion of the containment bag from the cannula arrangement. In such aspects, the third portion of the containment bag may be disposed within the second annular space. 
     In still another aspect of the present disclosure, distal advancement of the deployment plunger relative to the deployment cannula and the access cannula urges a portion of each of the engagement fingers distally from the deployment cannula and the access cannula. In such aspects, the engagement fingers may be biased towards a radially-outwardly extending configuration such that, upon extension thereof distally from the deployment cannula and the access cannula, the engagement fingers extend radially-outwardly. Alternatively or additionally, distal end portions of the engagement fingers may be configured for receipt within pockets defined within the containment bag. 
     In yet another aspect of the present disclosure, the deployment cannula further includes a proximal hub defining a central opening communicating with the second lumen and a plurality of channels radially-spaced from the central opening and configured to receive the plurality of engagement arms therethrough. The proximal hub of the deployment cannula may include a base portion and an insert portion releasably engagable with the base portion. Different insert portions may be interchangeable with the insert portion. 
     A method of containing a tissue specimen disposed within an internal body cavity provided in accordance with the present disclosure includes inserting a cannula arrangement through a vagina and into a pelvic cavity. The cannula arrangement includes an access cannula, a deployment cannula slidably disposed within the access cannula, a deployment plunger having a plurality of engagement arms slidably disposed within a first annular space defined between the access cannula and the deployment cannula, and an inner cannula slidably disposed within the deployment cannula. A containment bag is disposed within the cannula arrangement. 
     The method further includes distally advancing the deployment cannula relative to the access cannula to deploy a first portion of the containment bag from the cannula arrangement, in the pelvic cavity, and at least partially about a tissue specimen, and distally advancing the deployment plunger relative to the deployment cannula and the access cannula to deploy a second portion of the containment bag from the cannula arrangement and into the pelvic cavity such that the containment bag is further disposed about the tissue specimen. 
     In aspects, the method further includes proximally withdrawing the inner cannula from the deployment cannula and reinserting the inner cannula distally through the deployment cannula to deploy a third portion of the containment bag from the cannula arrangement and into the pelvic cavity. 
     In aspects, the method further includes withdrawing the first portion of the containment bag from the pelvic cavity through an abdominal port. 
     In aspects, the method further includes inserting a tenaculum or a grasper through the inner cannula and grasping the specimen with the tenaculum or grasper to maintain the specimen in position or pull the specimen proximally during deployment of the first and/or second portions of the containment bag. 
     In aspects, the method further includes proximally withdrawing the inner cannula and inserting a morcellator through the deployment cannula and into the pelvic cavity within the containment bag. In such aspects, an insert portion of the deployment cannula is replaced with a different insert portion after proximally withdrawing the inner cannula and before inserting the morcellator. 
     Another system for removal of a tissue specimen from an internal body cavity includes an access cannula defining a lumen extending therethrough, a containment bag selectively deployable from the lumen of the access cannula and having an open distal end portion, and a suture arrangement extending from the open distal end portion of the containment bag. 
     The suture arrangement may include a plurality of sutures arranged such that first ends of the sutures are spaced-apart about and attached to the distal end portion of the containment bag. The second ends of the sutures are attached to one another. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The above and other aspects and features of the present disclosure will become more apparent in light of the following detailed description when taken in conjunction with the accompanying drawings wherein like reference numerals identify similar or identical elements and: 
         FIG. 1  is a side, longitudinal, cross-sectional view of a tissue specimen removal system provided in accordance with the present disclosure, disposed in an initial condition; 
         FIG. 2  is a side, longitudinal, cross-sectional view of the tissue specimen removal system of  FIG. 1 , disposed in a deployed condition; 
         FIG. 3  is an exploded view of the tissue specimen removal system of  FIG. 1 ; 
         FIG. 4  is a perspective view of a containment bag of the tissue specimen removal system of  FIG. 1 ; 
         FIG. 5  is a side, perspective view of an end portion of the containment bag of  FIG. 4  and a deployment cannula of the tissue specimen removal system of  FIG. 1 , illustrating the deployment cannula moving into engagement with the containment bag; 
         FIG. 6  is a side, cut-away view of the distal portion of the tissue specimen removal system of  FIG. 1 , illustrating the deployment cannula engaged with the containment bag within the access cannula in the initial condition of the system; 
         FIG. 7A  is a side, cut-away view of a distal portion of the tissue specimen removal system of  FIG. 1 , illustrating one configuration of the containment bag collapsed within an access cannula of the tissue specimen removal system of  FIG. 1  in the initial condition of the system; 
         FIG. 7B  is a side, cut-away view of the distal portion of the tissue specimen removal system of  FIG. 1 , illustrating another configuration of the containment bag collapsed within the access cannula in the initial condition of the system; 
         FIG. 7C  is a side, cut-away view of the distal portion of the tissue specimen removal system of  FIG. 1 , illustrating another configuration of the containment bag collapsed within the access cannula in the initial condition of the system; 
         FIGS. 8A-8H  illustrate use of the tissue specimen removal system of  FIG. 1  for deploying the containment bag about a large tissue specimen within an internal body cavity, enclosing the large tissue specimen within the containment bag, breaking down the large tissue specimen into smaller pieces, and removing the contained pieces from the internal body cavity; 
         FIGS. 9A-9F  are longitudinal, cross-sectional views of another tissue specimen removal system provided in accordance with the present disclosure, illustrating the various positions thereof; 
         FIGS. 10A-10F  illustrate use of the tissue specimen removal system of  FIGS. 9A-9F  for deploying a containment bag about a large tissue specimen within an internal body cavity, enclosing the large tissue specimen within the containment bag, and breaking down the large tissue specimen into smaller pieces to enable removal from the internal body cavity; 
         FIGS. 11A-11F  illustrate another containment bag provided in accordance with the present disclosure and the use thereof in conjunction with a tissue specimen removal system to enclose a tissue specimen therein within an internal body cavity; and 
         FIG. 12  illustrates a tissue-strip cutting device provided in accordance with the present disclosure shown in use breaking down a tissue specimen into smaller tissue strips. 
     
    
    
     DETAILED DESCRIPTION 
     The present disclosure provides devices, systems, and methods facilitating removal of a large tissue specimen from an internal body cavity, e.g., pelvic cavity, while maintain the large tissue specimen in an enclosed environment during break down and removal from the internal body cavity. 
     Turning to  FIGS. 1-3 , a system  10  provided in accordance with the present disclosure generally includes an access cannula  100 , a deployment cannula  200 , and a containment bag  300 . Access cannula  100  includes a proximal hub  110 , an elongated tubular sleeve  120 , and a beveled distal end portion  130 . A lumen  140  extends through proximal hub  110  and elongated tubular sleeve  120  to enable the insertion of deployment cannula  200 , containment bag  300 , and, in some embodiments, other surgical instruments, through access cannula  100  and into the internal body cavity. 
     Proximal hub  110  of access cannula  100  is configured to remain externally-disposed and may include an insufflation port (not shown) to enable the introduction of insufflation fluid through lumen  140  and into the internal body cavity to insufflate the internal body cavity. To this end, proximal hub  110  may further include one or more seals (not shown) configured to seal lumen  140  in the absence of deployment cannula  200 , containment bag  300 , and/or other surgical instruments inserted therethrough, and/or to establish a seal about deployment cannula  200 , containment bag  300 , and/or other surgical instruments inserted through lumen  140 , in order to maintain the internal body cavity in an insufflated condition. 
     Elongated tubular sleeve  120  of access cannula  100  is configured to extend through an access opening an into the internal body cavity such that beveled distal end portion  130  is at least partially disposed within the internal body cavity, while proximal hub  110  remains externally disposed. For example, elongated tubular sleeve  120  may be configured to extend through the vagina into the pelvic cavity or, if the cervix is still intact, through the vagina and an incision in the posterior vaginal fornix into the pelvic cavity. Beveled distal end portion  130  of access cannula  100  is configured to facilitate atraumatic insertion of elongated tubular sleeve  120  through an access opening and into the internal body cavity, although configurations other than beveled are also contemplated. 
     Continuing with reference to  FIGS. 1-3  deployment cannula  200  includes a proximal hub  210 , an elongated tubular sleeve  220 , and a plurality of engagement fingers  230 . A lumen  240  extends through proximal hub  210  and elongated tubular sleeve  220  to enable the insertion of surgical instruments through deployment cannula  200  and into the internal body cavity. Deployment cannula  200  is configured for slidable positioning within lumen  140  of access cannula  100  and may be positioned therein in an initial condition ( FIG. 1 ) during manufacturing or may be inserted into access cannula  100  by a user. 
     Proximal hub  210  of deployment cannula  200  is configured to remain externally-disposed relative to the internal surgical site and access cannula  100 . More specifically, in an initial condition ( FIG. 1 ) of system  10 , proximal hub  210  is proximally-spaced from proximal hub  110  of access cannula  100 . In a deployed condition ( FIG. 2 ), on the other hand, proximal hub  210  is positioned proximally adjacent proximal hub  110 . Similarly as with proximal hub  110  of access cannula  100 , proximal hub  210  of deployment cannula  200  may include one or more seals (not shown) configured to seal lumen  240  in the absence of surgical instruments inserted therethrough and/or to establish a seal about surgical instruments inserted through lumen  140 , in order to maintain the internal body cavity in an insufflated condition. Proximal hub  210  of deployment cannula  200  may also include an insufflation port (not shown) to enable the introduction of insufflation fluid through lumen  240  to, for example, insufflate containment bag  300 . 
     Elongated tubular sleeve  220  of deployment cannula  200  is configured to extend through lumen  140  of access cannula  100  and into the internal body cavity. More specifically, elongated tubular sleeve  220  defines a suitable length so as to enable proximal hub  210  of deployment cannula  200  to remain externally disposed of the internal body cavity and access cannula  100  while a distal end of elongated tubular sleeve  220  extends to or beyond beveled distal end portion  130  of access cannula  100 . Further, elongated tubular sleeves  220  defines a suitable diameter relative to that of lumen  140  of access cannula  100  to enable positioning of elongated tubular sleeve  220  within lumen  140  of access cannula  100  with engagement fingers  230  and containment bag  300  disposed between elongated tubular sleeve  220  of deployment cannula  200  and elongated tubular sleeve  120  of access cannula  100 . 
     Engagement fingers  230  are configured as cantilever springs each having a fixed end  232  and a free end  234 . Although only two engagement fingers  230  are illustrated in the drawings, any suitable number of engagement fingers  230  may be provided. Engagement fingers  230  may be formed from a spring-metal, e.g., nitinol, or other suitable material, and are arranged radially-spaced about elongated tubular sleeve  220 . More specifically, engagement fingers  230  are fixed to the exterior surface of elongated tubular sleeve  220  at the fixed ends  232  thereof and extend distally to free ends  234  thereof. Free ends  234  of engagement fingers  230  extend distally beyond the distal end of elongated tubular sleeve  220  and are biased radially-outwardly from elongated tubular sleeve  220  in the at-rest positions of engagement fingers  230 . In the initial condition of system  10  (see  FIG. 1 ), wherein elongated tubular sleeve  220  of deployment cannula  200  is disposed within lumen  140  of access cannula  100 , engagement fingers  230  are retained, against their bias, in a contracted configuration, wherein engagement fingers  230  extend alongside the exterior of elongated tubular sleeve  220 , thus enabling engagement fingers  230  and elongated tubular sleeve  220  to fit within lumen  140  of access cannula  100 . Once deployment cannula  200  is advanced distally relative to access cannula  100  to the deployed condition ( FIG. 2 ) of system  10 , engagement fingers  230  extend distally from beveled distal end portion  130  of access cannula  100 , thus enabling engagement fingers  230  to return under bias towards their at-rest position, wherein free ends  234  of engagement fingers  230  are radially-outwardly spaced from elongated tubular sleeve  220 . 
     As an alternative to providing deployment cannula  200  with engagement fingers  230 , engagement fingers  230  may be disposed on another surgical instrument to be used within the internal body cavity such as, for example, a morcellator (not shown). An exemplary morcellator for this purpose is described in Patent Application Publication No. US 2015/0073429, filed on Jun. 12, 2014, the entire contents of which are hereby incorporated herein by reference. 
     Referring to  FIGS. 3 and 4 , containment bag  300  is configured for positioning, in the initial condition ( FIG. 1 ) of system  10 , in the annular space defined between elongated tubular sleeve  120  of access cannula  100  and elongated tubular sleeve  220  of deployment cannula  200 , although a portion of containment bag  300  may extend proximally from both access cannula  100  and deployment cannula  200  in the initial condition ( FIG. 1 ) of system  10 . In the deployed condition ( FIG. 2 ) of system  10 , containment bag  300  is deployed into the internal body cavity under urging from deployment cannula  200  and is unfurled, thus presenting containment bag  300  to enable positioning of a tissue specimen(s) therein. 
     Containment bag  300  includes a first open end portion  310 , a second open end portion  320 , and a body portion  330  disposed between first and second open end portions  310 ,  320 , respectively. First and second open end portions  310 ,  320 , respectively, need not be disposed opposite one another but can be arranged relative to one another and body portion  330  so as to define any suitable configuration such as, for example, a dogleg, L-shape, C-shape, or other suitable configuration. The particular configuration of containment bag  300  may depend upon the desired access locations to be used during the tissue specimen removal procedure. Containment bag  300  may be formed from any suitable material. In particular, containment bag  300  may be formed from a transparent, tear-resistant, stretchable material to enable visualization into containment bag  300  from the exterior thereof, inhibit tearing, and facilitate manipulation of containment bag  300 , tissue specimen(s), and/or surgical instrumentation during use. 
     First open end portion  310  of containment bag  300  defines a generally tubular, elongated configuration of sufficient length to enable first open end portion  310  to extend from the internal body cavity, through access cannula  100 , to the exterior of the patient. This configuration separates the interior of containment bag  300  from surrounding patient tissue. First open end portion  310  of containment bag  300  may further include features (not shown) to facilitate sealed closure thereof such as, for example, a threaded lip configured to receive a screw-on cap, or may be configured to be sealed closed by way of a suture, clip, tying-off, or other suitable mechanism or method. 
     Second open end portion  320  of containment bag  300  likewise defines a generally tubular, elongated configuration. Second open end portion  320  defines a beveled end  321  and is of sufficient length to enable second open end portion  320  to extend from the internal body cavity, through a second access cannula  1100  ( FIGS. 8A-8H ), different from access cannula  100 , to the exterior of the patient. Thus, first and second open end portions  310 ,  320  are capable of extending through access cannulas  100  ( FIG. 1 ),  1100  ( FIGS. 8A-8H ), respectively, while body portion  330  of containment bag  300  is disposed within the internal body cavity. In addition or as an alternative to the features of first open end portion  310 , second open end portion  320  may further include features (not shown) to facilitate sealed closure thereof such as, for example, a threaded lip configured to receive a screw-on cap, or may be configured to be sealed closed by way of a suture, clip, tying-off, or other suitable mechanism or method. 
     With additional reference to  FIGS. 5 and 6 , second open end portion  320  of containment bag  300  further includes a plurality of elongated pockets  322  disposed on an interior surface thereof. Elongated pockets  322  are arranged radially-spaced about the interior surface of second open end portion  320  of containment bag  300  and may correspond in number and position to the number and position of engagement fingers  230  of deployment cannula  200  (see  FIG. 3 ). Each elongated pocket  322  defines a proximally-facing open end  324   a  configured to receive the free end  234  of one of the engagement fingers  230  of deployment cannula  200 , and a closed, distally-facing end  234   b . As such, engagement fingers  230  are configured to slide into elongated pockets  322  upon distal insertion of deployment cannula  200  into containment bag  300 . As an alternative, engagement fingers  230  may be external to containment bag  320  and pockets  322  likewise disposed on the external side thereof. 
     In the initial condition ( FIGS. 1 and 6 ) of system  10 , deployment cannula  200  extends into containment bag  300  such that engagement fingers  230  are received within elongated pockets  322 , with both deployment cannula  200  and containment bag  300  disposed within access cannula  100 . In the deployed condition ( FIG. 2 ) of system  10 , the bias of engagement fingers  230  towards the radially-outwardly spaced position relative to elongated tubular sleeve  220  similarly expands second open end portion  320  of containment bag  300  providing a mouth  326  to facilitate passage of a tissue specimen into second open end portion  320  of containment bag  300 . 
     Referring to  FIGS. 3, 4, and 7A-7C , second open end portion  320  of containment bag  300  defines a reinforced rim  327  surrounding the opening thereof. Reinforced rim  327  may be formed from a spring-metal, e.g., nitinol, or other suitable material that is resiliently flexible, returning to a pre-determined shape in the absence of external forces applied thereto. This configuration allows reinforced rim  327  to be flexed or otherwise re-positioned to enable receipt of second open end portion  320  of containment bag  300  within lumen  140  of access cannula  100 . Upon deployment from lumen  140  of access cannula  100 , reinforced rim  327  returns to its at-rest configuration, thus maintaining mouth  326  in an open, expanded position to facilitate passage of a tissue specimen into second open end portion  320  of containment bag  300 . First open end portion  310  of containment bag  300  may likewise define a reinforced rim (not shown) surrounding the opening thereof to facilitate maintaining the opening of first open end portion  310  in an open condition externally of the internal body cavity or, in embodiments, within the internal body cavity upon deployment from access cannula  100 . 
     With reference to  FIG. 7A , in embodiments, reinforced rim  327  may be manipulated to define an oval-shaped configuration and may be angled relative to lumen  140  of access cannula  100  to enable reinforced rim  327  to fit within lumen  140  of access cannula  100  in the initial condition of system  10  ( FIG. 1 ). Alternatively, as illustrated in  FIG. 7B , reinforced rim  327  may be manipulated to define an oval-shaped configuration and then bent to define a distally-facing C-shaped configuration to enable reinforced rim  327  to fit within lumen  140  of access cannula  100  in the initial condition of system  10  ( FIG. 1 ).  FIG. 7C  illustrates another alternative, wherein reinforced rim  327  is manipulated to define an oval-shaped configuration and then bent to define a proximally-facing C-shaped configuration to enable reinforced rim  327  to fit within lumen  140  of access cannula  100  in the initial condition of system  10  ( FIG. 1 ). Other suitable configurations are also contemplated. 
     Referring again to  FIGS. 4-6 , second open end portion  320  of containment bag  300  further includes a grasping tab  328  extending from beveled end  321  thereof. More specifically, grasping tab  328  extends from the further-extended side of beveled end  321  to facilitate grasping of tab  328 . Tab  328  may further include an aperture  329  configured to receive a tooth, hook, or other suitable structure of a grasper “G” ( FIG. 8D ) to facilitate grasping of tab  328 . As detailed below, the grasping of tab  328  enables manipulation of second open end portion  320  of containment bag  300  within the internal body cavity and/or withdrawal of second open end portion  320  from the internal body cavity. 
     With reference to  FIG. 4 , body portion  330  of containment bag  300  defines an enlarged diameter relative to first and second open end portions  310 ,  320 , respectively, of containment bag  300  and is disposed therebetween. Body portion  330  is configured for positioning within the internal body cavity while either or both of first and second open end portions  310 ,  320 , respectively, extend from the internal body cavity, through an access cannula  100 ,  1100  ( FIGS. 8A-8H ), to the exterior of the patient. Body portion  330  is configured to receive a tissue specimen to be removed and, with the tissue specimen disposed within body portion  330 , enable breaking down, e.g., via morcellation, of the tissue specimen into smaller pieces to facilitate removal from the internal body cavity. 
     Turning to  FIGS. 8A-8H , in conjunction with  FIGS. 1-3 , the use of system  10  in the removal of a large tissue specimen “S” from the pelvic cavity “U,” maintaining the large tissue specimen “S” in an enclosed environment during break down and removal, is described. System  10  may be similarly used in the removal of other tissue specimen from other internal body cavities. 
     Referring initially to  FIG. 8A , with system  10  disposed in the initial condition, access cannula  100 , lead by beveled distal end  130  of elongated tubular sleeve  120 , is advanced through the vagina “V” into the pelvic cavity “U” or, if the cervix is still intact, through the vagina “V” and an incision in the posterior vaginal fornix into the pelvic cavity “U.” In the initial condition of access cannula  100 , first open end portion  310  of containment bag  300  remains externally of access cannula  100  and the pelvic cavity “U” or, alternatively, may be disposed within access cannula  100  similarly as second open end portion  320  of containment bag  300 . 
     Second and third access cannulas  1100 ,  2100 , respectively, may be inserted through the abdomen into the pelvic cavity “U” to establish triangulation between the access cannulas  100 ,  1100 ,  2100 . A surgical camera “C” may be inserted through one of the second or third access cannulas  1100 ,  2100 , e.g., third access cannula  2100 , to enable visualization of the interior of the pelvic cavity “U.” 
     Next, as illustrated in  FIG. 8B , system  10  is transitioned from the initial condition to the deployed condition to deploy second open end portion  320  of containment bag  300  into the pelvic cavity “U.” As detailed above, deployment of containment bag  300  is accomplished by moving deployment cannula  200  distally through access cannula  100  until proximal hub  210  of deployment cannula  20  is positioned proximally adjacent proximal hub  110  of access cannula  100 . As a result of this movement of deployment cannula  200 , as also detailed above, engagement fingers  230  are expanded towards the radially-outwardly spaced position and reinforced rim  327  of second open end portion  320  of containment bag  300  is unfurled such that second open end portion  320  of containment bag  300  is expanded and mouth  326  presented to facilitate passage of tissue specimen “S” into second open end portion  320  of containment bag  300 . 
     With reference to  FIG. 8C , with second open end portion  320  of containment bag  300  deployed within the pelvic cavity “U,” a tenaculum “T,” or other suitable grasper, may be inserted through lumen  240  of deployment cannula  200  and through containment bag  300  to grasp the tissue specimen “S” and pull the tissue specimen “S” through mouth  326  and into containment bag  300 , as illustrated in  FIG. 8D . Visualization to facilitate positioning of the tissue specimen “S” within containment bag  300  may be provided via surgical camera “C.” The triangulation of access cannulas  100 ,  1100 ,  2100  provides an advantageous point of view for surgical camera “C” during the positioning of the tissue specimen “S” within containment bag  300 . 
     Continuing with reference to  FIG. 8D , once the tissue specimen “S” is moved into containment bag  300 , grasper “G” may be inserted through second access cannula  1100  to grasp tab  328  of containment bag  300 . Under visualization from surgical camera “C,” with grasper “G” grasping tab  328  of containment bag  300 , grasper “G” may be retracted back through second access cannula  1100  bringing second open end portion  320  of containment bag  300  therewith (see also  FIG. 8E ). Before or after withdrawal of second open end portion  320  of containment bag  300 , access cannula  1100  may be removed and re-inserted through second open end portion  320 . Alternatively, access cannula  1100  may remain in position with second open end portion  320  of containment bag  300  extending therethrough. Tenaculum “T” may be maintained in position or moved in an opposite direction to ensure the tissue specimen “S” remains within containment bag  300 . In either configuration, the triangulation of access cannulas  100 ,  1100 ,  2100  provides an advantageous point of view for surgical camera “C” during the retrieval of second open end portion  320  of containment bag  300  from the pelvic cavity “U.” Further, containment bag  300  may be insufflated at this point, or at any other suitable juncture, to maximize visualization within containment bag  300 . 
     Referring to  FIG. 8E , with containment bag  300  containing the tissue specimen “S” within body portion  330  thereof and with first and second open end portions  310 ,  320 , respectively, extending externally of the pelvic cavity “U,” tenaculum “T” and deployment cannula  200  may be removed from access cannula  100  in favor of a morcellator “M” that is inserted through first open end portion  310  of containment bag  300  and into body portion  330  thereof adjacent the tissue specimen “S.” Alternatively, morecellator “M” may be inserted through second open end portion  320  via access cannula  1100  and surgical camera “C” through first end portion  310  via access cannula  100 . In embodiments where morcellator “M” also serves as the deployment cannula  200 , no removal is thus required. In either configuration, with additional reference to  FIG. 8F , tenaculum “T” may be used in conjunction with morcellator “M” to break down the tissue specimen “S.” More specifically, as with respect to the morcellator disclosed in Patent Application Publication No. US 2015/0073429, previously incorporated herein by reference, the tissue specimen “S” may be broken down by cutting the tissue specimen “S” into smaller strips “SS.” Other suitable mechanical, electrical, or electromechanical morcellators, for use with or without tenaculum “T,” are also contemplated. 
     Surgical camera “C” may be inserted through second access cannula  1100  and second open end portion  320  of containment bag  300  to provide visualization within containment bag  300  during morcellation of the tissue specimen “S” or, alternatively, may be disposed through third access cannula  2100  to enable visualization through containment bag  300 , in embodiments where containment bag  300  is transparent. 
     With reference to  FIG. 8G , once tissue specimen “S” is sufficiently broken down into smaller strips “SS,” morcellator “M” and tenaculum “T” may be removed from access cannula  100  and first open end portion  310  of containment bag  300  sealed off. Alternatively or additionally, second open end portion  320  of containment bag  300  may be sealed off. Referring also to  FIG. 8H , containment bag  300  may then withdrawn from the pelvic cavity “U” through one of the abdominal openings such that first open end portion  310  is first pulled into pelvic cavity “U” and follows out through the abdominal opening, e.g., through one of the access cannulas  1100 ,  2100 , or through one of the openings where access cannulas  1100 ,  2100  were disposed. Alternatively, containment bag  300  may be withdrawn through the vagina “V” such that second open end portion  320  (which is first sealed closed in such embodiments) is first pulled into pelvic cavity “U” and follows out through the vagina “V.” In either configuration containment bag  300  may be removed through one of the access cannulas  100 ,  1100 ,  2100  or the access cannula(s)  100 ,  1100 ,  2100  may be removed prior to withdrawal of containment bag  300 . 
     Turning to  FIGS. 9A-9F , another system  3010  is provided in accordance with the present disclosure that facilitates removal of a large tissue specimen from an internal body cavity while maintaining the large tissue specimen in an enclosed environment during break down and removal from the internal body cavity. System  3010  generally includes an access cannula  3100 , a deployment cannula  3200  slidably receivable within access cannula  3100 , a containment bag  3300  (not shown in  FIGS. 9A-9F , see  FIGS. 10A-10F ) selectively deployable from access cannula  3100 , a deployment plunger  3400 , and an inner cannula  3500 . 
     Access cannula  3100  may be similar to and/or include any of the features of access cannula  100  ( FIG. 1 ), detailed above. Access cannula  3100  generally includes a proximal hub  3110 , an elongated tubular sleeve  3120 , and defines a lumen  3140  extending therethrough. 
     Deployment cannula  3200  includes a proximal hub  3210  and an elongated tubular sleeve  3220  extending distally from proximal hub  3210 . Deployment cannula  3200  also defines a lumen  3240  extending therethrough. Proximal hub  3210  includes a base  3212  and an insert  3214  seated within base  3212 . Insert  3214  may be removable from base  3212  and retainable therein via friction-fitting (provided by an O-ring  3216  disposed about insert  3214 , for example), or may be removably retainable within base  3212  in any other suitable fashion. Thus, insert  3214  may be replaced with a different insert, e.g., insert  3215  ( FIG. 9F ), having a different configuration, depending upon the instrumentation to be inserted therethrough. Alternatively, insert  3214  may be permanently seated within base  3212 . Insert  3214  defines a central aperture  3218 , defining the proximal portion of lumen  3240 , that is configured to receive inner cannula  3500  and/or other instrumentation therethrough. Insert  3214  further defines a plurality of channels  3219  defined therethrough and positioned radially about central aperture  3218 . Channels  3219  are positioned radially outside elongated tubular sleeve  3220 . As shown, two diametrically opposed channels  3219  are defined through insert  3214 . However, any suitable number and/or positioning of channels  3129  may be provided. 
     Elongated tubular sleeve  3220  of deployment cannula  3200 , as noted above, extends distally from proximal hub  3210 . Elongated tubular sleeve  3220  of deployment cannula  3200  defines a reduced diameter as compared to elongated tubular sleeve  3120  of access cannula  3100  so as to define an annular spacing  3222  therebetween when deployment cannula  3200  is received within access cannula  3100 . Further, with deployment cannula  3200  received within access cannula  3100 , channels  3219  of insert  3214  are aligned and communicate with annular spacing  3222 . Elongated tubular sleeve  3220  defines a length sufficiently greater than that of elongated tubular sleeve  3120  of access cannula  3100  such that, with deployment cannula  3200  fully received within access cannula  3100 , elongated tubular sleeve  3220  extends distally from elongated tubular sleeve  3120 . 
     Deployment plunger  3400  includes a proximal base  3410  and a plurality of engagement fingers  3430  extending therefrom. Although only two diametrically opposed engagement fingers  3430  are illustrated in the drawings, any suitable number of engagement fingers  3430  may be provided, and may correspond to the number and positioning of channels  3219  of insert  3214  to enable slidable positioning of fingers  3430  through channels  3219  and into annular spacing  3222  defined between elongated tubular sleeve  3220  of deployment cannula  3200  and elongated tubular sleeve  3120  of access cannula  3100 . Engagement fingers  3430  are configured as cantilever springs biased radially-outwardly in the at-rest positions thereof. However, when received within channels  3219  and/or annular spacing  3222 , engagement fingers  3430  are retained in a substantially linear configuration against the bias thereof. Engagement fingers may further be configured similar to engagement fingers  230 , detailed above ( FIG. 3 .) 
     Inner cannula  3500  includes a proximal hub  3510  and an elongated tubular sleeve  3520  extending distally from proximal hub  3510 . Inner cannula  3500  also defines a lumen  3540  extending therethrough. Proximal hub  3510  is configured for insertion at least partially into central aperture  3218  of insert  3214  of deployment cannula  3200  and may be releasably retainable therein via friction-fitting (provided by an O-ring  3512  disposed about proximal hub  3510 , for example). Proximal hub  3510  further defines a central opening  3518 , defining the proximal end of lumen  3540 , that is configured to receive instrumentation therethrough. 
     Elongated tubular sleeve  3520  of inner cannula  3500 , as noted above, extends distally from proximal hub  3510 . Elongated tubular sleeve  3520  of inner cannula  3500  defines a reduced diameter as compared to elongated tubular sleeve  3220  of deployment cannula  3200  so as to define an annular spacing  3522  therebetween when inner cannula  3500  is received within deployment cannula  3200 . Further, elongated tubular sleeve  3520  defines a length sufficiently greater than that of elongated tubular sleeve  3220  of deployment cannula  3200  such that, with proximal hub  3510  fully seated within central aperture  3218  of insert  3214  of deployment cannula  3200 , elongated tubular sleeve  3520  extends further distally than elongated tubular sleeve  3220 . As such, with inner cannula  3500  fully received within deployment cannula  3200  and with deployment cannula  3200  fully received within access cannula  3100 , elongated tubular sleeve  3520  also extends distally from elongated tubular sleeve  3120 . 
     With additional reference to  FIGS. 10A-10F , containment bag  3300  may be configured similar to containment bag  300  ( FIGS. 3-7C ), detailed above, and may include any or all of the features thereof. Containment bag  3330 , similar to containment bag  300  ( FIGS. 3-7C ), is configured for positioning, in an initial condition of system  3010 , within access cannula  3100 , and is deployable therefrom to a deployed condition of system  3010 , wherein containment bag  3300  is deployed into the internal body cavity under urging from deployment cannula  3200 , deployment plunger  3400 , and inner cannula  3500 , and is unfurled, thus presenting containment bag  3300  to enable positioning of a tissue specimen therein. Containment bag  3330  may be fully deployed into the internal body cavity, or a portion of containment bag  3300  may extend proximally from access cannula  3100  and remain externally thereof, similarly as detailed above with respect to containment bag  300  ( FIGS. 8A-8H ). Alternatively, one end portion of containment bag  3300  may be attached (removably or permanently) to one of the components of system  3010 , e.g., access cannula  3100 , deployment cannula  3200 , or inner cannula  3500 . Likewise, in other embodiments, rather than being externalized, one end portion of the containment bag may be attached to one of the components of the deployment system thereof. Such a configuration allows for access of different devices (e.g., tenaculum, grasper, morcellator, etc.) into the specimen bag while maintaining pneumoperitoneum, and also helps control the excess bag material and improve usability. Further, as detailed below, containment bag  3300  may be deployed into the internal body cavity in two or more stages, although a single, continuous deployment is also contemplated. 
     In the initial condition of system  3010 , a distal portion of containment bag  3300  (including the furled, reinforced rim thereof), is maintained within lumen  3140  of access cannula  3100  distally of deployment cannula  3200 ; an intermediate portion of containment bag  3300  is disposed within annular spacing  3222  defined between elongated tubular sleeve  3220  of deployment cannula  3200  and elongated tubular sleeve  3120  of access cannula  3100 ; and a proximal portion of containment bag  3300  is disposed within annular spacing  3522  defined between elongated tubular sleeve  3520  of inner cannula  3500  and elongated tubular sleeve  3220  of deployment cannula  3200 , although part of the proximal portion may also extend proximally from deployment cannula  3200  and remain externally, similarly as detailed above with respect to system  10  ( FIGS. 8A-8H ). Other configurations for containment bag  3300 , in the initial condition of system  3010 , are also contemplated. 
     Deployment of containment bag  3300  from the above-noted initial condition of system  3010  to the deployed condition thereof, as detailed below, is effected in a plurality of stages: initially by distal advancement of deployment cannula  3200  relative to access cannula  3100  to deploy the distal portion of containment bag  3300 ; further via distal advancement of deployment plunger  3400  relative to deployment cannula  3200  and access cannula  3100  to deploy the intermediate portion of containment bag  3300 ; and, finally, by withdrawal and re-insertion of access cannula  3500  to and from deployment cannula  3200 , to deploy some or all of the proximal portion of containment bag  3300 . 
     Referring to  FIGS. 10A-10F , in conjunction with  FIGS. 9A-9F , the use of system  3010  in the removal of a large tissue specimen “S” from the pelvic cavity “U,” maintaining the large tissue specimen “S” in an enclosed environment during break down and removal, is described. System  3010  may be similarly used in the removal of other tissue specimen from other internal body cavities. Further, use of system  3010  and additional instrumentation used therewith, e.g., abdominal ports, surgical cameras, graspers, etc., are similar to that detailed above with respect to system  10  ( FIGS. 8A-8H ) and, thus, only differences will be detailed below while similarities are summarily described or omitted entirely for purposes of brevity. 
     Referring initially to  FIGS. 9A and 10A , with system  3010  disposed in the initial condition, access cannula  3100  is advanced through the vagina “V” into the pelvic cavity “U” or, if the cervix is still intact, through the vagina “V” and an incision in the posterior vaginal fornix into the pelvic cavity “U.” Next, as illustrated in  FIGS. 9B and 10B , system  3010  is transitioned from the initial condition to a partially-deployed condition to deploy the distal portion of containment bag  3300  into the pelvic cavity “U.” This partial deployment is accomplished by moving deployment cannula  3200 , together with deployment plunger  3400 , distally relative to access cannula  3100  until proximal hub  3210  of deployment cannula  3200  is positioned proximally adjacent proximal hub  3110  of access cannula  3100 . Although deployment plunger  3400  is moved distally, it remains fixed relative to deployment cannula  3200 , whereby proximal base  3410  of deployment plunger  3400  is proximally-spaced from proximal hub  3210  of deployment cannula  3200 . As a result of the above-detailed movement of deployment cannula  3200  and deployment plunger  3400 , the distal end of deployment cannula  3200  urges the distal portion of containment bag  3300  distally from lumen  3140  of access cannula  3100  and into the pelvic cavity “U.” In addition, engagement fingers  3430  of deployment plunger  3400  are partially extended into the pelvic cavity “U” to facilitate deployment of containment bag  3300 . However, the majority of containment bag  3330  remains disposed within access cannula  3100 . 
     With reference to  FIGS. 9C and 10C , in order to further deploy containment bag  3300  about tissue specimen “S,” a tenaculum “T” is inserted through inner cannula  3500  and into the pelvic cavity “U” to grasp the tissue specimen “S” and either maintain the tissue specimen “S” in position or pull the tissue specimen “S” towards access cannula  3100 . With the tenaculum “T” grasping the tissue specimen “S,” deployment plunger  3400  is advanced distally relative to access cannula  3100  and deployment cannula  3200  such that engagement arms  3420  are advanced distally through channels  3219 , annular spacing  3222 , and further into the pelvic cavity “U” to urge containment bag  3300  distally from access cannula  3100  further into the pelvic cavity “U” and about the tissue specimen “S.” Engagement arms  3420  may be configured to engage containment bag  3300  similarly as detailed above with respect to system  10  ( FIGS. 8A-8H ) to facilitate deployment thereof, or may be configured to deploy containment bag  3300  in any other suitable fashion. 
     Referring also to  FIGS. 9D, 9E, 10D, and 10E , in order to complete deployment of containment bag  3300 , deployment plunger  3400  is retracted proximally back to its initial position, or removed entirely. In addition, inner cannula  3500  is momentarily withdrawn proximally from deployment cannula  3200 , allowing the portion of containment bag  3300  disposed within annular spacing  3322  to collapse into lumen  3240  of deployment cannula  3200  and occupy more space thereof. Inner cannula  3500  may then be re-inserted into deployment cannula  3200  to urge the repositioned portion of containment bag  3300  distally therefrom and into the pelvic cavity “U.” 
     Prior to or after withdrawal and re-insertion of inner cannula  3500 , the distal portion of containment bag  3300  may be withdrawn through an abdominal port, similarly as detailed above with respect to system  10  ( FIGS. 8A-8H ). 
     Next, as shown in  FIGS. 9F and 10F , inner cannula  3500  may once again be removed, along with deployment plunger  3400  (if not removed already). If necessary, insert  3214  may be replaced with a different insert  3215  having a different, e.g., larger, internal diameter, and a morcellator “M” inserted through insert  3215  and through deployment cannula  3200  into the pelvic cavity “U.” Of course, if replacement is not required, e.g., if a larger diameter is not needed, insert  3214  may be utilized. Insufflation of containment bag  3300  may also be accomplished at this point, if required. Once morcellator “M” is inserted into position, tenaculum “T” may be inserted through morcellator “M” to grasp and/or manipulate the tissue specimen “S” during morcellation. Completion of morcellation and removal of the containment bag  3300  with the tissue specimen “S” therein may be accomplished similarly as detailed above with regard to system  10  ( FIGS. 8A-8H ). Further, similarly as detailed above with regard to system  10  ( FIGS. 8A-8H ), some or all of the above may be performed under observation using a surgical camera inserted from an abdominal port. 
     Turning to  FIGS. 11A-11F , another containment bag provided in accordance with the present disclosure is shown generally identified by reference numeral  4300 . Containment bag  4300  may be similar to and include any or all of the features of containment bag  300  ( FIGS. 4-6 ) except that, rather than a grasping tab  328  ( FIGS. 4-6 ) to facilitate manipulation of the second open end portion within an internal body cavity, insertion of a tissue specimen through the second open end portion, and/or withdrawal of the second open end portion from the internal body cavity, containment bag  4300  includes a suture arrangement  4330 . Containment bag  4300  may be utilized in conjunction with any or all of the devices, systems, and methods detailed above. 
     Suture arrangement  4330  includes a plurality of sutures, e.g., first, second, and third sutures  4332 ,  4334 ,  4336 , respectively. However, although three (3) sutures  4332 ,  4334 ,  4336  are illustrated and described herein, any suitable number of sutures may be provided. Sutures  4332 ,  4334 ,  4336  are attached at first ends thereof to second open end portion  4320  of containment bag  4300  about the annular periphery thereof. More specifically, sutures  4332 ,  4334 ,  4336  are spaced-apart about at least a portion of the annular periphery of second open end portion  4320  of containment bag  4300 . In embodiments, the first ends of sutures  4332 ,  4334 ,  4336  are equally-spaced about at least a portion of the annular periphery of second open end portion  4320  of containment bag  4300 . However, sutures  4332 ,  4334 ,  4336  need not be equally-spaced, nor do sutures  4332 ,  4334 ,  4336  need to extend about the entire annular periphery of second open end portion  4320  of containment bag  4300 . Rather, the first ends of sutures  4332 ,  4334 ,  4336  may be disposed in any suitable configuration to facilitate manipulation of second open end portion  4320  of containment bag  4300 , insertion of a tissue specimen “S” through the second open end portion  4320  and into containment bag  4300 , and/or withdrawal of second open end portion  4320  from an internal body cavity, e.g., the pelvic cavity “U.” 
     The second ends of sutures  4332 ,  4334 ,  4336  may be joined to one another via knotting or in any other suitable manner or via any other suitable mechanism such as, for example, using a cuff  4338  ( FIG. 11A ). Alternatively, the second ends of sutures  4332 ,  4334 ,  4336  may remain unattached. In embodiments where the second ends of sutures  4332 ,  4334 ,  4336  are attached, and as detailed below, the second ends of sutures  4332 ,  4334 ,  4336  may collectively be withdrawn from the pelvic cavity “U” through a single access cannula, e.g., additional access cannula  5200 . In embodiments where the second ends of sutures  4332 ,  4334 ,  4336  remain unattached, on the other hand, the second ends of two or more of the sutures  4332 ,  4334 ,  4336  may be withdrawn from the pelvic cavity “U” through different access cannulas, although they may also be withdrawn through the same access cannula. 
     In embodiments, additional sutures (not shown) may be attached to one or more of sutures  4332 ,  4334 ,  4336  towards either end thereof, at either end thereof, or at an intermediate portion thereof. The additional sutures (not shown), for example, may extend between and interconnect intermediate portions of sutures  4332 ,  4334 ,  4336 , or may extend from one or more of sutures  4332 ,  4334 ,  4336  with the second ends thereof joined with the second ends of sutures  4332 ,  4334 ,  4336 . Other suitable configurations are also contemplated. 
     Suture arrangement  4330  provides triangulation about second open end portion  4320  of containment bag  4300 . This triangulation, more specifically, allows sutures  4332 ,  4334 ,  4336  to be grasped and manipulated to maneuver second open end portion  4320  of containment bag  4300  within the pelvic cavity “U” while maintaining second open end portion  4320  of containment bag  4300  in proper orientation to accept the tissue specimen “S” therethrough. This triangulation also facilitates advancement of second open end portion  4320  of containment bag  4300  about the tissue specimen “S” via manipulating sutures  4332 ,  4334 ,  4336 , and, ultimately, withdrawal of sutures  4332 ,  4334 ,  4336  and second open end portion  4320  of containment bag  4300  from the pelvic cavity “U.” 
     In use, with reference to  FIG. 11A , containment bag  4300  is initially disposed within a cannula  5100  (which may be the cannula of any of the systems disclosed hereinabove or any other suitable cannula or cannula system) in an initial condition and cannula  5100  is advanced through the vagina “V” into the pelvic cavity “U” or, if the cervix is still intact, through the vagina “V” and an incision in the posterior vaginal fornix into the pelvic cavity “U.” One or more access cannulas  5200  may be inserted through the abdomen into the pelvic cavity “U,” prior to or after insertion of cannula  5100 . 
     With additional reference to  FIG. 11B , one or more graspers “G” may be inserted through the one or more additional access cannulas  5200  and manipulated to grasp the second ends of sutures  4332 ,  4334 ,  4336  (collectively or independently) of suture arrangement  4330 . More specifically, in embodiments where the second ends of sutures  4332 ,  4334 ,  4336  are attached to one another, e.g., via cuff  4338 , one grasper “G” may be utilized to grasp cuff  4338  and pull cuff  4338  through the pelvic cavity “U” towards additional access cannula  5200 . In this manner, second open end portion  4320  of containment bag  4300  is deployed from cannula  5100  and into the pelvic cavity “U.” 
     Referring to  FIGS. 11C-11E , with second open end portion  4320  of containment bag  4300  deployed within the pelvic cavity “U,” a tenaculum “T,” or other suitable grasper, may be inserted through cannula  5100  and through containment bag  4300  to grasp the tissue specimen “S.” With the tenaculum “T” grasping the tissue specimen “S” to maintain the tissue specimen “S” stationary or drawing the tissue specimen “S” proximally towards cannula  5100 , the second ends of sutures  4332 ,  4334 ,  4336  are pulled in a generally opposing direction such that second open end portion  4320  of containment bag  4300  is likewise pulled in the generally opposing direction, e.g., towards additional access cannula  5200 . As detailed above, the triangulation provided by suture arrangement  4330  helps ensure that second open end portion  4320  of containment bag  4300  is maintained in an open condition and oriented towards the tissue specimen “S” as it is pulled towards about the tissue specimen “S” such that the tissue specimen “S” is received within second open end portion  4320  of containment bag  4300 . Ultimately, the second ends of sutures  4332 ,  4334 ,  4336  are pulled out of the pelvic cavity “U” through additional access cannula  5200 . 
     With additional reference to  FIG. 11F , the second ends of sutures  4332 ,  4334 ,  4336  are withdrawn through additional access cannula  5200  sufficiently such that sutures  4332 ,  4334 ,  4336  and second open end portion  4320  of containment bag  4300  are likewise pulled out of the pelvic cavity “U” through additional access cannula  5200 , leaving the tissue specimen “S” disposed within containment bag  4300  within the pelvic cavity “U” with the first open end portion of containment bag  4300  and second open end portion  4320  thereof extending through different cannulas  5100 ,  5200  externally of the pelvic cavity “U.” The above-detailed use of containment bag  4300  may otherwise be similar to and include any of the features of the above-described devices, systems, and methods. For example, the tissue specimen “S” may be broken down by cutting the tissue specimen “S” into smaller strips “SS” ( FIGS. 8F-8H ) to facilitate removal from the pelvic cavity “U,” the first open end portion of containment bag  4300  may be sealed off, and containment bag  4300  may be withdrawn from the pelvic cavity “U” through additional access cannula  5200 . 
     Turning now to  FIG. 12 , as mentioned above, the tissue specimen “S” may be broken down by cutting the tissue specimen “S” into smaller strips “SS” to facilitate removal from the pelvic cavity “U.” A tissue-strip cutting device provided in accordance with the present disclosure and suitable for the purpose is detailed below and generally identified by reference numeral  6000 . Tissue-strip cutting device  6000  is not limited for use with the devices, systems, and methods detailed herein but, rather, may be used with various other devices, systems, and methods to cut a tissue specimen “S” into smaller strips “SS.” Similarly, the above-detailed devices, systems, and methods need not employ tissue-strip cutting device  600  but may utilize any other suitable device(s) for cutting the tissue specimen “S” into smaller strips “SS.” 
     Tissue-strip cutting device  6000  includes an elongated tubular member  6100 , a grasper  6200 , and a cutting element  6300 . Elongated tubular member  6100 , grasper  6200 , and cutting element  6300  may be coupled to one another as part of an integral device or may be separate from one another. Elongated tubular member  6100  may be insertable through an access cannula, e.g., through access cannula  100  and into containment bag  300  ( FIGS. 8E-8F ), or may be an access cannula itself. In either configuration, elongated tubular member  6100  defines a lumen  6110  extending longitudinally therethrough. 
     Grasper  6200  is configured to extend through lumen  6110  of elongated tubular member  6100  and distally therefrom such that working end  6210  of grasper  6200  may extend into an internal surgical site, e.g., into containment bag  300  disposed within the pelvic cavity “U” (see  FIGS. 8E-8F ), for positioning adjacent the tissue specimen “S” to be cut into smaller strips “SS.” Grasper  6200  is configured to grasp a portion of the tissue specimen “S” to maintain the tissue specimen “S” in substantially fixed position relative to grasper  6200  and elongated tubular member  6100 . Working end  6210  may include a pair of pivotable jaw members  6220 , or any other suitable component(s), that enable grasping of the tissue specimen “S” therewith. 
     Cutting element  6300  includes a pair of elongated, spaced-apart rods  6310  interconnected at their respective distal ends via a U-shaped loop  6320  that depends from rods  6310 . Rods  6310  are formed at least partially from an electrically-conductive material and may be covered with an insulative coating or sheath (not shown). U-shaped loop  6320  is likewise formed from an electrically-conductive material and may be integral with or engaged and electrically coupled to rods  6310 . Either or both of rods  6310  is adapted to connect to a source of electrosurgical energy, e.g., RF energy, to enable the selective energization of U-shaped loop  6320 . U-shaped loop  6320  may function as a monopolar electrode for use with a remote return pad (not shown), or may function as one electrode in a bipolar configuration, with another component, e.g., a portion of grasper  6200 , a portion of elongated tubular member  6100 , or other suitable component, severing as the other electrode. 
     Cutting element  6300  is configured to extend through lumen  6110  of elongated tubular member  6100  and distally therefrom. More specifically, cutting element  6300  is selectively translatable through and relative to elongated tubular member  6100  between a distal position (illustrated in phantom in  FIG. 12 ), wherein U-shaped loop  6320  is further-spaced distally from elongated tubular member  6100 , and a proximal position (illustrated in  FIG. 12 ), wherein U-shaped loop  6320  is closer to elongated tubular member  6100 . As detailed below, movement of cutting element  6300  from the distal position to the proximal position while energy is supplied to U-shaped loop  6320  serves to cut an elongated strip “SS” of tissue from tissue specimen “S.” 
     Continuing with reference to  FIG. 12 , in use, elongated tubular member  6100  is inserted through an access cannula or directly into the internal surgical site adjacent the tissue specimen “S” to be broken down and removed. As noted above, in embodiments, elongated tubular member  6100  may be inserted into a containment bag, e.g., containment bag  300  ( FIG. 8E ), disposed within the internal surgical site and containing the tissue specimen “S” to be broken down and removed therein. 
     With elongated tubular member  6100  inserted as detailed above, grasper  6200  may be manipulated to grasp the tissue specimen “S” with working end  6210  thereof to thereby maintain the tissue specimen “S” substantially stationary relative to elongated tubular member  6100  and grasper  6200 . 
     With the tissue specimen “S” retained in position, cutting element  6300 , if not done so already, may be advanced distally to the distal position and tissue-strip cutting device  6000  manipulated such that a portion of the tissue specimen “S” is disposed between U-shaped loop  6320  of cutting element  6300  and the distal end of elongated tubular member  6100 . Once cutting element  6300  has reached the distal position (or a sufficiently-distal position such that a portion of the tissue specimen “S” is disposed between U-shaped loop  6320  and elongated tubular member  6100 ), cutting element  6300  is energized and translated proximally relative to elongated tubular member  6100 , grasper  6200 , and, thus, the tissue specimen “S.” As a result, a smaller tissue strip “SS” is electromechanically cut from the tissue specimen “S.” 
     The above-detailed cutting of smaller tissue strips “SS” from the tissue specimen “S” may be repeated until the remaining portion of the tissue specimen “S” is sufficiently small so as to allow for minimally-invasive removal. The smaller tissue strips “SS” may be removed, one or more at a time, through elongated tubular member  6100 , e.g., using grasper  6200 , or may be removed together with the containment bag  300  ( FIGS. 8E-8H ). 
     From the foregoing and with reference to the various drawings, those skilled in the art will appreciate that certain modifications can be made to the present disclosure without departing from the scope of the same. While several embodiments of the disclosure have been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.