Patent Publication Number: US-10327745-B2

Title: Surgical retrieval apparatus for thoracic procedures

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application is a continuation of U.S. patent application Ser. No. 13/649,305 filed Oct. 11, 2012, now U.S. Pat. No. 8,968,329, which claims benefit of U.S. Provisional Application No. 61/549,015 filed Oct. 19, 2011, and the disclosures of each of the above-identified applications are hereby incorporated by reference in their entirety. 
    
    
     BACKGROUND 
     Technical Field 
     The present disclosure relates to a retrieval apparatus, and more particularly, to a surgical retrieval apparatus for use in thoracic surgical procedures. 
     Background of Related Art 
     In minimally invasive surgical procedures, operations are carried out within the body by using elongated instruments inserted through small entrance openings in the body. The initial opening in the body tissue to allow passage of instruments to the interior of the body may be a natural passageway of the body, or it can be created by a tissue piercing instrument such as a trocar, or created by a small incision into which a cannula is inserted. 
     Because the tubes, instrumentation, and any required punctures or incisions are relatively small, the surgery is less invasive as compared to conventional surgical procedures in which the surgeon is required to cut open large areas of body tissue. Therefore, minimally invasive surgery minimizes trauma to the patient and reduces patient recovery time and hospital costs. 
     Minimally invasive procedures may be used for partial or total removal of body tissue or organs from the interior of the body, e.g. nephrectomy, cholecystectomy, lobectomy and other procedures including thoracic, laparoscopic and endoscopic procedures. During such procedures, it is common that a cyst, tumor, or other affected tissue or organ needs to be removed via the access opening in the skin, or through a cannula. Various types of entrapment devices have been disclosed to facilitate this procedure. In many procedures where cancerous tumors are removed, removal of the specimen in an enclosed environment is highly desirable to inhibit seeding of cancer cells. 
     In minimally invasive thoracic surgery, access to the thoracic cavity is limited as well as maneuverability within the cavity as the access port is placed between the confined space between a patient&#39;s ribs. Such procedures, commonly referred to as video assisted thorascopic surgery (VATS), aim to reduce patient recovery time by accessing the thoracic cavity through the natural intercostal space without spreading the ribs as in open procedures. This restricted access can sometimes cause problems when removing large specimens. Moreover, in such procedures, e.g. thorascopic wedge resection and lobectomy, it is often necessary to remove a portion of the lung and retrieve it relatively intact for pathology. It is also important that the specimen be sufficiently contained to inhibit seeding of cancer cells during manipulation and removal. 
     In designing such specimen retrieval instrumentation, a balance must be struck between the need to provide a retrieval apparatus with a strong enough containment bag to inhibit tearing or rupture while providing sufficient rigidity to enable manipulation and removal. Another balance which needs to be achieved is to provide sufficient maneuverability while reducing tissue trauma, e.g. damaging lung tissue, during manipulation and removal. Additionally, the instrumentation on one hand should be able to be inserted through a small access incision or port while on the other hand able to accommodate a wide range of patient sizes and be able to easily remove large specimens and minimize risk of seeding. 
     SUMMARY 
     In accordance with embodiments of the present disclosure, a surgical retrieval apparatus is provided. The surgical retrieval apparatus includes a handle defining a longitudinal axis and an elongated sleeve extending distally therefrom. The handle and the elongated sleeve cooperate to define a lumen extending longitudinally therethrough. A shaft having an end effector assembly disposed at a distal end thereof and a plunger disposed at a proximal end thereof is also provided. The shaft is selectively translatable through the lumen between a first position, and a second position, wherein the end effector assembly extends distally from the elongated sleeve. An articulation mechanism configured to articulate the end effector assembly relative to the shaft between a substantially aligned position and an articulated position is also provided. The handle is rotatable about the longitudinal axis and relative to the shaft to articulate the end effector assembly. A specimen retrieval bag is coupled, and preferably releasably coupled, to the end effector assembly and is configured to be deployable from an undeployed position to an extended position upon movement of the end effector assembly from the first position to the second position. The specimen retrieval bag further includes a cinch cord disposed about an open end thereof. 
     In some embodiments, the cinch cord is removably coupled to the plunger at an end thereof and is configured, upon release from the plunger, for selective proximal translation to cinch closed the specimen retrieval bag. 
     In some embodiments, articulation of the end effector assembly is inhibited when the shaft is disposed in the first position. 
     In some embodiments, the handle may define an articulation track on an inner surface thereof. The articulation track may be configured to receive an articulation post of the articulation mechanism therein such that the articulation post is translated along the track upon rotation of the handle assembly about the longitudinal axis and relative to the shaft to articulate the end effector assembly. Further, the articulation mechanism may include an articulation bar coupled to the end effector assembly at a distal end thereof and the articulation post disposed at a proximal end thereof. The articulation bar is disposed within the shaft and be translatable relative to the shaft upon rotation of the handle assembly relative to the shaft to articulate the end effector assembly relative to the shaft 
     In some embodiments, the shaft is manually translatable between the first and second positions. The handle may include one or more finger holes to facilitate manipulation of the handle. 
     In some embodiments, a safety tab is configured to engage both the handle and the shaft when the shaft is disposed in the first position. The safety tab inhibits relative movement between the handle and the shaft. 
     In some embodiments, a pull-member is releasably coupled to the plunger and configured to engage the end of the cinch cord thereon such that, upon release from the plunger, the pull-member is translatable proximally to cinch closed the specimen retrieval bag. Further, the plunger may include one or more resilient lock tabs configured to releasably engage the pull-member thereon. The plunger may also include one or more flanges extending outwardly therefrom that are configured to facilitate translation of the shaft between the first and second positions. 
     In some embodiments, translation of the shaft from the second position back to the first position separates the specimen retrieval bag from the end effector assembly and/or at least partially cinches closed the specimen retrieval bag. 
     A method of specimen retrieval using the specimen retrieval apparatus of any of the above-embodiments is also provided in accordance with the present disclosure. The method includes positioning the surgical retrieval apparatus within an internal body cavity, translating the shaft distally through the lumen from a first position to a second position such that the end effector assembly extends distally from the elongated sleeve to deploy the specimen retrieval bag, articulating the end effector assembly relative to the shaft from a substantially aligned position to an articulated position by rotating the handle about the longitudinal axis relative to the shaft, positioning a specimen of tissue within the specimen retrieval bag, articulating the end effector assembly back to the substantially aligned position, translating the shaft proximally from the second position back to the first position such that the end effector assembly is disposed within the elongated sleeve, disengaging the cinch cord from the plunger, and translating the cinch cord proximally to cinch closed the specimen retrieval bag about the specimen of tissue. 
     In some embodiments, the method further includes cutting the cinch cord to release the specimen retrieval bag from the shaft. Thereafter, the cut end of the cinch cord may be translated proximally to remove the specimen retrieval bag from the internal body cavity. 
     In some embodiments, prior to positioning the surgical retrieval apparatus within the internal body cavity, a safety tab coupled to both the handle and the shaft is removed to permit translation of the shaft relative to the handle. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Various embodiments of the subject surgical retrieval apparatus are described herein with reference to the drawings wherein: 
         FIG. 1  is a side, perspective view of one embodiment of a surgical retrieval apparatus in accordance with the present disclosure, shown in a deployed (extended) position; 
         FIG. 2  is a side, perspective view of the surgical retrieval apparatus of  FIG. 1 , shown in a retracted (insertion/removal) position; 
         FIG. 3  is an exploded, perspective view of the surgical retrieval apparatus of  FIG. 1 ; 
         FIG. 4  is an enlarged, perspective view of a distal portion of the surgical retrieval apparatus of  FIG. 1 , showing an end effector coupled to a shaft thereof; 
         FIG. 5  is an enlarged, perspective view of a proximal portion of the surgical retrieval apparatus of  FIG. 1 ; 
         FIG. 6  is an exploded, perspective view of the handle portion of the surgical retrieval apparatus of  FIG. 1 ; 
         FIG. 7  is a transverse, cross-sectional view of the handle portion of the surgical retrieval apparatus of  FIG. 1 ; 
         FIG. 8  is a side, cut-away view of a specimen retrieval bag configured for use with the surgical retrieval apparatus of  FIG. 1 ; 
         FIG. 9  is an enlarged, perspective view of a proximal end of the specimen retrieval bag of  FIG. 8 ; 
         FIG. 10  is a side, longitudinal cross-sectional view of the surgical retrieval apparatus of  FIG. 1 , shown in the retracted position; 
         FIG. 11  is a top, longitudinal cross-sectional view of the surgical retrieval apparatus of  FIG. 1 , shown in the retracted position; 
         FIG. 12  is an enlarged, top, longitudinal cross-sectional view of a proximal end of the surgical retrieval apparatus of  FIG. 1 , shown in the retracted position; 
         FIG. 13  is an enlarged, side, longitudinal cross-sectional view of the area of detail designated in  FIG. 10  showing the distal end of the surgical retrieval apparatus of  FIG. 1 , in the retracted position; 
         FIG. 14  is an enlarged, top, longitudinal cross-sectional view of a distal end of the surgical retrieval apparatus of  FIG. 1 , shown in the retracted position; 
         FIG. 15  is an enlarged, side, longitudinal cross-sectional view of the area of detail designated in  FIG. 10  showing the distal end of the surgical retrieval apparatus of  FIG. 1 , in the retracted position; 
         FIG. 16  is an enlarged, longitudinal cross-sectional view of a plunger configured for use with the surgical retrieval apparatus of  FIG. 1 ; 
         FIG. 17  is a side, perspective view of the plunger of  FIG. 16 ; 
         FIG. 18  is a side, perspective view of the surgical retrieval apparatus of  FIG. 1 , shown being inserted through an incision in tissue; 
         FIG. 19  is a transverse, cross-sectional view of the surgical retrieval apparatus of  FIG. 18 , shown being inserted through an incision in tissue and into an internal surgical site (e.g., the thoracic cavity); 
         FIG. 20  is an enlarged, side, longitudinal cross-sectional view of the proximal end of the surgical retrieval apparatus of  FIG. 1 , shown in the deployed position; 
         FIG. 21  is a transverse, cross-sectional view of the proximal end of the surgical retrieval apparatus of  FIG. 1  taken along line  21 - 21  of  FIG. 20 , shown in the deployed position; 
         FIG. 22  is a transverse, cross-sectional view of the surgical retrieval apparatus of  FIG. 1 , shown disposed within an internal surgical site in the deployed position; 
         FIG. 23  is an enlarged, side perspective view of a proximal end of an end effector assembly of the surgical retrieval apparatus of  FIG. 1 , showing a cinch cord of the specimen retrieval bag thereof; 
         FIG. 24  is a side, perspective view of the surgical retrieval apparatus of  FIG. 1 , shown in an articulated position; 
         FIG. 25  is a longitudinal cross-sectional view of the surgical retrieval apparatus of  FIG. 1 , shown in the articulated position; 
         FIG. 26  is a enlarged, longitudinal cross-sectional view of the area of detail of  FIG. 25  showing the proximal end of the surgical retrieval apparatus of  FIG. 1  in the articulated position; 
         FIG. 27  is an enlarged, longitudinal cross-sectional view of the distal end of the surgical retrieval apparatus of  FIG. 1 , shown in the articulated position; 
         FIG. 28  is a transverse, cross-sectional view of the proximal end of the surgical retrieval apparatus of  FIG. 1  taken along line  27 - 27  of  FIG. 25  and in the articulated position; 
         FIG. 29  is a transverse, cross-sectional view of the surgical retrieval apparatus of  FIG. 1 , shown disposed within an internal surgical site in the deployed and articulated position with a specimen of tissue disposed within the specimen retrieval bag; 
         FIG. 30  is a side, perspective view of the surgical retrieval apparatus of  FIG. 1 , shown inserted through an incision in tissue and returning to the retracted position; 
         FIG. 31  is a side view of the distal end of the surgical retrieval apparatus of  FIG. 1 , wherein the specimen retrieval bag is being cinched closed about a specimen of tissue disposed therein; 
         FIG. 32  is a side, perspective view of the proximal end of the surgical retrieval apparatus of  FIG. 1 , showing a pull-member being translated to cinch closed the specimen retrieval bag; 
         FIG. 33  is a side view of the distal end of the surgical retrieval apparatus of  FIG. 1 , wherein the specimen retrieval bag has been cinched closed to retain a tissue specimen therein; 
         FIG. 34  is a transverse, cross-sectional view showing the specimen retrieval bag being removed through the incision in tissue with a specimen of tissue disposed therein; 
         FIG. 35  is a side, perspective view of another embodiment of a surgical retrieval apparatus provided in accordance with the present disclosure; 
         FIG. 36  is an exploded, perspective view of the surgical retrieval apparatus of  FIG. 35 ; 
         FIG. 37  is an enlarged, perspective view of a plunger of the surgical retrieval apparatus of  FIG. 35 ; 
         FIG. 38  is a side, perspective view of yet another embodiment of a surgical retrieval apparatus provided in accordance with the present disclosure; and 
         FIG. 39  is a perspective view of a proximal end of the surgical retrieval apparatus of  FIG. 38 . 
     
    
    
     DETAILED DESCRIPTION 
     Various embodiments of the presently disclosed surgical retrieval apparatus, and methods of using the same, will now be described in detail with reference to the drawings wherein like references numerals identify similar or identical elements. In the drawings, and in the following description, the term “proximal” should be understood as referring to the end of the apparatus, or component thereof, that is closer to the clinician during proper use, while the term “distal” should be understood as referring to the end that is farther from the clinician, as is traditional and conventional in the art. 
     Although the presently disclosed surgical retrieval apparatus is discussed with respect to minimally invasive thoracic procedures, it is within the scope of the present disclosure that the surgical retrieval apparatus is readily adaptable for use in other minimally invasive surgical procedures. 
     Turning now to  FIGS. 1-3 , a surgical retrieval apparatus in accordance with the present disclosure is shown generally identified by reference numeral  10 . Surgical retrieval apparatus  10  defines a longitudinal axis “X-X” and generally includes a handle  100  having an elongated sleeve  120  fixedly engaged thereto and extending distally therefrom, and a shaft  200  having an end effector assembly  220  disposed at a distal end  202  thereof, an articulation assembly  240  coupled thereto, and a plunger assembly  260  disposed at a proximal end  204  thereof. As will be described in detail below, shaft  200  and end effector assembly  220  are longitudinally translatable through and relative to handle  100  and elongated sleeve  120  to transition surgical retrieval apparatus  10  between a first, initial, insertion/removal, or retracted position ( FIG. 2 ) and a second, extended, or deployed position ( FIG. 1 ). Further, once the deployed position has been achieved, handle  100  may be rotated about longitudinal axis “X-X” and relative to shaft  200  to articulate end effector assembly  220  off of longitudinal axis “X-X,” i.e., to define an acute angle between end effector assembly  220  and shaft  200 . 
     Handle  100  is formed from a pair of cooperating housing components  104 ,  106 , e.g., via snap-fitting, and includes a generally-cylindrical body portion  110  having a pair of opposed wings  112  extending outwardly therefrom. Each wing  112  includes a finger hole  114  defined therethrough that is configured to receive fingers of the clinician to facilitate grasping and/or manipulating surgical retrieval apparatus  10 . As mentioned above, elongated sleeve  120  extends distally from handle  100 . More specifically, elongated sleeve  120  includes one or more notches  124  defined therein that are configured to receive one or more complementary protrusions  116  of body portion  110  of handle  100  to fixedly secure elongated sleeve  120  within body portion  110  of handle  100  upon engagement between components  104 ,  106  of handle  100 . Further, body portion  110  of handle  100  and elongated sleeve  120  together define a lumen  122  disposed about longitudinal axis “X-X” and extending distally from proximal aperture  108  of handle  100 , through body portion  110  of handle  100 , and through elongated sleeve  120  to distal end  126  thereof, i.e., lumen  122  extends completely through surgical retrieval apparatus  10  along longitudinal axis “X-X” thereof. 
     Elongated sleeve  120  is configured for insertion through an opening in tissue, e.g., through a thoracic surgical access portal  300  ( FIGS. 18-19 ) disposed within an incision “I” ( FIGS. 18-19 ) in tissue “T” ( FIGS. 18-19 ) between adjacent ribs “R” ( FIG. 19 ) of a patient. As such, it is envisioned that elongated sleeve  120  define a sufficient length such that elongated sleeve  120  may be advanced into the thoracic cavity “C” ( FIG. 19 ) to a position adjacent a tissue specimen “S” ( FIG. 29 ) to be removed, while handle  100  remains external of the patient. Further, it is envisioned that elongated sleeve  120  define a diameter sufficiently large to permit passage of end effector assembly  220  and shaft  200  therethrough, but sufficiently small such that elongated sleeve  120  may be inserted between adjacent ribs “R” ( FIG. 19 ) of a patient, i.e., through thoracic access portal  300  ( FIGS. 18-19 ) disposed within an incision “I” ( FIGS. 18-19 ) in the intercostal space. 
     As mentioned above, shaft  200  includes a plunger assembly  260  disposed at proximal end  204  thereof, an end effector assembly  220  disposed at distal end  202  thereof, and an articulation assembly  240  coupled thereto for articulating end effector assembly  220  relative to shaft  200 . Further, shaft  200  is slidably positionable within lumen  122  of handle  100  and elongated sleeve  120  and is configured for longitudinal translation therethrough between the retracted position ( FIG. 2 ), wherein shaft  200  is retracted proximally relative to handle  100  and elongated sleeve  120  such that end effector assembly  220  is disposed within lumen  122 , i.e., such that end effector assembly  220  does not extend from distal end  126  of sleeve  120 , and the deployed position ( FIG. 1 ), wherein shaft  200  is translated distally through lumen  122  such that end effector assembly  220  extends distally from distal end  126  of elongated sleeve  120  to deploy specimen retrieval bag  30 . 
     With continued reference to  FIGS. 1-3 , shaft  200  includes a bifurcated proximal end  204  and plunger assembly  260  includes a protrusion  262  extending from base  261  thereof that is configured to be received within the bifurcated proximal end  204  of shaft  200 . A pin  264  inserted through each of the bifurcated portions of proximal end  204  of shaft  200  and through protrusion  262  of plunger assembly  260  secures plunger assembly  260  to proximal end  204  of shaft  200 . 
     Plunger assembly  260  further includes a handle  265  extending proximally from base  261 . Handle  265  defines a central, annular portion  266  having an aperture  267  extending therethrough and a pair of lateral grasping flanges  268  extending outwardly from annular portion  266  to facilitate the grasping of plunger assembly  260  to retract plunger assembly  260  and, thus, shaft  200  relative to handle  100  and elongated sleeve  120 , e.g., from the deployed position ( FIG. 1 ) back to the retracted position ( FIG. 2 ). 
     A pull-ring  280  is removably disposed within plunger assembly  260 . Pull-ring  280  is coupled to cinch cord  230  of specimen retrieval bag  30  and includes a lip  282  extending inwardly into central opening  286  thereof that facilitates the grasping of pull-ring  280  for disengaging pull-ring  280  from plunger assembly  260  and retracting pull-ring  280  relative to plunger assembly  260  to tension cinch cord  230 . More specifically, pull-ring  280  is releasably engagable within recessed rim  272  of plunger assembly  260 , which is disposed about aperture  267 , via a plurality of resilient lock tabs  274  ( FIG. 16 ). A more detailed description of pull-ring  280 , including the operation thereof, will be described hereinbelow. 
     Continuing with reference to  FIGS. 1-3 , in conjunction with  FIG. 4 , end effector assembly  220  is pivotably coupled to shaft  200  and articulation assembly  240 . End effector assembly  220  includes a pair of arms  222 ,  224  configured for positioning within loop  34  formed at open end  33  of specimen retrieval bag  30  to retain specimen retrieval bag  30  thereon. In the deployed position, as shown in  FIG. 1 , arms  222 ,  224  of end effector assembly  220  define a spaced-apart, curvate configuration for retaining specimen retrieval bag  30  thereon in an open condition, although other configurations are also contemplated, e.g., end effector assembly  200  may include linear arms  222 ,  224 . Articulation assembly  240  includes a rotatable member  242 , an articulation linkage  250 , and an articulation bar  254  that is disposed within an elongated, longitudinally-extending recess  206  defined within shaft  200 , thus permitting articulation bar  254  to translate through recess  206  relative to shaft  200 . 
     Arms  222 ,  224  of end effector assembly  220  are pivotably coupled to shaft  200  via rotatable member  242  of articulation assembly  240 . More particularly, arms  222 ,  224  of end effector assembly  220  each include a first aperture  226 ,  227 , respectively, and a second aperture  228 ,  229 , respectively, longitudinally-spaced from first aperture  226 ,  227 , respectively. Apertures  226 ,  228  and  227 ,  229  of respective arms  222 ,  224  are defined therethrough at proximal ends  223 ,  225 , respectively, thereof. Rotatable member  242  similarly includes first and second longitudinally-spaced apertures  243 ,  244 , respectively, defined therethrough. A first pin  247  is secured through first aperture  226  of arm  222 , first aperture  243  of rotatable member  242 , and first aperture  227  of arm  224 . A second pin  248  is secured through apertures  208  defined within each portion of the at least partially bifurcated distal end  202  of shaft  200  and through second apertures  228 ,  229  of arms  222 ,  224 , respectively, and second aperture  244  of rotatable member  242 . As can be appreciated, such a configuration fixedly secures arms  222 ,  224  and rotatable member  242  to one another, e.g., via the first and second pins  247 ,  248 , respectively, engaged therebetween, and pivotably couples rotatable member  242  and arms  222 ,  224  of end effector assembly  220  to distal end  202  of shaft  200 , e.g., via second pin  248 . Alternatively, arms  222 ,  224  may be overmolded, or otherwise formed with rotatable member  242 . 
     A third pin  249  is disposed through third aperture  245  of rotatable member  242 , which is offset above and distally of second pin  248 , the pivot point between rotatable member  242  (and end effector assembly  220 ) and shaft  200 . Third pin  249  pivotably couples articulation linkage  250  to rotatable member  242  at first end  251  thereof. Articulation linkage  250  is pivotably coupled to distal end  255  of articulation bar  254  at second end  253  thereof. Articulation bar  254  is disposed within recess  206  of shaft  200  and, as will be described in greater detail below, is longitudinally translatable therethrough to urge, i.e., push or pull, articulation linkage  250 . Pulling articulation linkage  250  proximally, for example, pulls pin  249  proximally, thereby rotating rotatable member  242  and arms  222 ,  224  about second pin  248  to articulate arms  222 ,  224  of end effector assembly  220  off of longitudinal axis “X-X,” defining an acute angle between arms  222 ,  224  and longitudinal axis “X-X” of shaft  200 . Pushing articulation linkage  250  distally, on the other hand, urges pin  249  distally, thereby rotating rotatable member  242  and arms  222 ,  224  about second pin  248  to articulate aims  222 ,  224  of end effector assembly  220  back towards longitudinal axis “X-X” (i.e., back towards the substantially aligned position). 
     Turning now to  FIGS. 5-7 , in conjunction with  FIGS. 1-3 , articulation bar  254  of articulation assembly  240  includes an articulation post  258  extending generally perpendicularly from articulation bar  254  at proximal end  256  thereof. Articulation post  258  defines a height sufficient to extend from recess  206  of shaft  200  such that articulation post  258  engages within articulation track  130  defined on inner surfaces  105 ,  107  of handle components  104 ,  106 , respectively. As will be described in detail below, with articulation post  258  engaged within articulation track  130 , articulation bar  254  may be selectively translated relative to shaft  200  upon selective rotation of handle  100  about longitudinal axis “X-X” relative to shaft  200  to articulate end effector assembly  220  off of longitudinal axis “X-X.” More particularly, as best shown in  FIG. 5 , elongated sleeve  120  includes a longitudinal slot  128  extending from proximal end  127  thereof that is configured to receive articulation post  258  therethrough, thus allowing articulation post  258  to extend from articulation bar  254 , shaft  200 , through elongated sleeve  120 , and into engagement with articulation track  130 . 
     Articulation track  130 , as shown in  FIGS. 6-7 , includes a longitudinal portion  132  and a helical portion  136 , and is formed partially within each of handle components  105 ,  107  such that, upon engagement of handle components  105 ,  107  to one another, articulation track  130  is fully formed. As mentioned above, articulation track  130  is configured to receive articulation post  258  therein. More specifically, upon translation of shaft  200  from the retracted position ( FIG. 2 ) to the deployed position ( FIG. 1 ) to deploy end effector assembly  220  and specimen retrieval bag  30 , articulation post  258  is translated distally along longitudinal portion  132  of articulation track  130  into position adjacent helical portion  136  thereof. Longitudinal portion  132  of articulation track  130  extends generally parallel relative to longitudinal axis “X-X” and inhibits rotation of handle  100  about longitudinal axis “X-X” and relative to shaft  200  when shaft  200  is disposed in the retracted position due to the engagement of articulation post  258  within articulation track  130 . Accordingly, articulation of end effector assembly  220  when shaft  200  is disposed in the retracted position is inhibited at both the proximal end  204  of shaft  200 , due to the engagement of articulation post  258  within longitudinal portion  132  of articulation track  130 , as well as at the distal end  202  of shaft  200 , due to the internal dimensions of lumen  122  of elongated sleeve  120 , which inhibit substantial movement of end effector assembly  200  off of longitudinal axis “X-X” when disposed therein. 
     With reference to  FIGS. 1-3 and 5-7 , upon translation of shaft  220  to the deployed position, however, articulation post  258  is translated along longitudinal portion  132  of articulation track  130  into position adjacent helical portion  136  of articulation track  130 . In this position, handle  100  may be rotated about longitudinal axis “X-X” and relative to shaft  200  to translate articulation post  258  through helical portion  136  and relative to shaft  200 . Further, with end effector assembly  220  extending from lumen  122  of elongated sleeve  120 , arms  222 ,  224  are no longer confined within lumen  122  elongated sleeve  120 . Thus, as can be appreciated, translation of articulation post  258  through helical portion  136  of articulation track  130  may be effected to translate articulation post  258  and, thus, articulation bar  154  relative to shaft  200  to articulate of end effector assembly  220  relative to longitudinal axis “X-X.” Such articulation provides increased flexibility in the placement of specimen retrieval bag  30  within the body cavity, e.g. thoracic cavity “C” ( FIG. 19 ). It also enables specimen retrieval bag  30  to be placed away from the immediate space adjacent the main access incision “I” ( FIGS. 18-19 ) and placed towards the apex of the cavity “C” ( FIG. 19 ). This provides the surgeon with a functional space immediately below the incision “I” ( FIGS. 18-19 ) where the specimen “S” ( FIG. 19 ) can be easily and directly manipulated and where the space can be visualized from the separate scope port (not shown). That is, the bag  30  can be out of the way of loading and visualization. 
     Referring now to  FIGS. 8-9 , in conjunction with  FIG. 3 , specimen retrieval bag  30  is removably coupled to end effector assembly  220  and depends therefrom. More specifically, specimen retrieval bag  30  is folded over at an open end  33  thereof to form a loop  34  around the outer periphery thereof. End effector assembly  220  includes a pair of arms  222 ,  224  configured for removable positioning within loop  34  formed at open end  33  of specimen retrieval bag  30  to retain specimen retrieval bag  30  thereon. In the deployed position, as shown in  FIG. 1 , arms  222 ,  224  of end effector assembly  220  define a spaced-apart, curvate configuration for retaining specimen retrieval bag  30  thereon in an open condition, although other configurations are also contemplated, e.g., end effector assembly  220  may include linear arms  222 ,  224 . In the retracted position, on the other hand, arms  222 ,  224  of end effector assembly  220  are disposed in a substantially-straight configuration in close proximity to one another to permit positioning within and translation through lumen  122  of elongated sleeve  120 . As will be described below, arms  222 ,  224  may be biased toward the spaced-apart, curvate configuration such that, upon reaching the deployed position, arms  222 ,  224  are automatically deployed, i.e., arms  222 ,  224  are resiliently returned, to the spaced-apart curvate configuration, thus transitioning specimen retrieval bag  30  to the open condition. 
     Continuing with reference to  FIGS. 8-9 , in conjunction with  FIG. 3 , as will be described in greater detail below, a cinch cord  230  is disposed through loop  34  of specimen retrieval bag  30 . First and second ends  232 ,  234 , respectively, of cinch cord  230  extend proximally from loop  34  of specimen retrieval bag  30 . One of the ends, e.g., first end  232 , is looped about the other end, e.g., second end  234 , and is knotted, or otherwise secured about itself (see  FIG. 23 ), while second end  234  extends proximally though shaft  200 , ultimately engaging, i.e., knotting about, pull-ring  280 . Accordingly, as will be described in greater detail below, upon translation of pull-ring  280  proximally relative to shaft  200 , cinch cord  230  is likewise pulled proximally to tension cinch cord  230  such that specimen retrieval bag  30  is cinched closed. Upon retraction of the apparatus, arms  222 ,  224  slide out of the loop  34  and the cord  230  is cut, preferably by a knife in the handle portion to separate the bag and cord from the instrument. 
     With continued reference to  FIGS. 8-9 , in conjunction with  FIG. 3 , it is envisioned that specimen retrieval bag  30  be formed from any suitable bio-compatible material (or materials), e.g., 30 Denier Ripstop Nylon, configured to retain a specimen of tissue “S” ( FIG. 29 ) therein and to inhibit the passage of fluids and biological materials therethrough. The bag  30  can include a coating, such as a polyurethane coating, to prevent egress of fluid if a permeable bag is utilized or to improve the impermeability. The coating can be placed on the inner surface and/or the outer surface of the bag  30 . Specimen retrieval bag  30  includes a lower portion  32  having a minimized cross-section configured to re-orient or re-position the specimen of tissue “S” ( FIG. 29 ) within specimen retrieval bag  30  to facilitate removal of specimen retrieval bag  30  from an internal body cavity, and a relatively expansive upper portion  35  configured to facilitate positioning of relatively large specimen of tissue “S” ( FIG. 29 ) within specimen retrieval bag  30 . In other words, lower portion  32  has a smaller transverse dimension than upper portion  35 . More specifically, upper portion  35  of specimen retrieval bag  30  has a first side  36  and a generally-angled side  37  disposed opposite first side  36 . Angled side  37  tapers inwardly such that the transverse dimension of upper portion  35  of specimen retrieval bag  30  progressively decreases toward the lower portion  32  of specimen retrieval bag  30 . Wall  38 , which opposes wall  39  in lower portion  32  of specimen retrieval bag  30 , extends substantially parallel to wall  39  such that the transverse dimension of lower portion  32  remains substantially constant along a length thereof. Alternatively, specimen retrieval bag  30  may be formed in various other configurations depending on the intended use of specimen retrieval bag  30 . 
     As mentioned above, open end  33  of upper portion  35  of specimen retrieval bag  30  includes a loop  33  defined about the outer periphery thereof. Loop  33  is configured to receive arms of end effector assembly  220  and cinch cord  230  therethrough for retaining specimen retrieval bag  30  on end effector assembly  220  and for cinching, or closing specimen retrieval bag  30 , respectively. 
     Specimen retrieval bag  30  may in some embodiments further include a high-friction mesh material disposed on an inner surface thereof to facilitate retention of the tissue specimen “S” ( FIG. 29 ) therein. In other embodiments, the bag shape is relied on to retain the specimen “S” ( FIG. 29 ) and a smooth inner surface is provided to enable easy passage of the tissue specimen “S” ( FIG. 29 ) from the upper loading area, i.e., upper portion  35 , of the bag  30  to the lower shaping region, i.e., lower portion  32 , of the bag  30  during extraction. 
     Specimen retrieval bag  30  further includes a channel  42  formed therein. The channel  42  can be formed as integral with the bag material or alternatively can be in the form of a separate tube attached to the bag  30 , e.g. attached to an inner surface. The channel  42  includes at least one opening or slot  44  along its length to allow the passage of air into the channel  42 . Preferably, a plurality of slots or openings are provided to enable communication between the air and/or fluid in the bag  30  and the interior of the channel  42 . The channel  42  in some embodiments can also terminate at its distal end spaced from the bottom of the bag  30  to communicate at a distal opening with the interior of the bag  30  to provide another path for the escape of air fluid. Further, the proximal end of channel  42 , in some embodiments, may be open to communicate with the exterior of the bag  30 . 
     A support member (or support members)  40  may be disposed within specimen retrieval bag  30  to help inhibit collapse of the channel  42  and/or for biasing specimen retrieval bag  30  toward an open position upon deployment from surgical retrieval apparatus  10 . Support member  40  may be formed from, for example, an open cell material such as open cell foam, or other suitable material that enables the passage of air and/or fluid therethrough, thus allowing air and/or fluid to escape specimen retrieval bag  30  upon collapse or compression of specimen retrieval bag  30  to reduce the internal pressure within specimen retrieval bag  30 . More specifically, the open cell foam is preferably of a transverse cross-section less than the transverse cross-section of the channel  42 . In this manner, air and/or fluid entering the channel  42  from the bag  30  can flow around the foam material through the channel  42 . Note that due to the open cell foam, the air or fluid can also flow through the open cell foam itself. This way, if the channel  42  collapses or is compressed during specimen retrieval, air and fluid can still escape. The escape of air and fluid is caused as the pressure is applied to the bag  30  during withdrawal through access port  300  ( FIG. 18 ), or body opening. As the bag  30  is compressed, the air and/or fluid is forced proximally through the channel  42 , exiting the open proximal end thereof. Thus, this decrease in pressure prevents balling of the specimen “S” ( FIG. 33 ) at the bottom of the bag  30  and facilitates removal. 
     Turning now to  FIGS. 10-34 , the use and operation of surgical retrieval apparatus  10  will be described along with a more detailed description of the working components of surgical retrieval apparatus  10 . Initially, with reference to  FIGS. 10-17 , surgical retrieval apparatus  10  is disposed in the retracted position, wherein shaft  200  extends proximally from handle  100  and wherein end effector assembly  220  and specimen retrieval bag  30  are disposed within lumen  122  of elongated sleeve  120 . 
     As best shown in  FIGS. 11-12 , shaft  200  may be configured to receive a safety tab  140  therethrough to inhibit accidental or premature deployment of shaft  200  and specimen retrieval bag  30 . More specifically, safety tab  140  is configured to extend through slot  210  defined within shaft  200  and to abut the proximal end of handle  100  to inhibit shaft  200  from being translated further distally through handle  100 , thereby inhibiting deployment of end effector assembly  220  and specimen retrieval bag  30 . More specifically, safety tab  140  includes a elongated portion  142  for insertion though slot  210  of shaft  200 , and an external grasping portion  144  to facilitate grasping by the clinician for removal of safety tab  140  from shaft  200 , thus permitting distal advancement (and proximal retraction) of shaft  200  through handle  100  and elongated sleeve  120  towards the deployed position (and retracted position). 
     Continuing with reference to  FIGS. 10-17 , in the retracted position, the internal dimensions of lumen  122  of elongated sleeve  120  retain arms  222 ,  224  of end effector assembly  220  therein in the substantially-straight, approximated position with specimen retrieval bag  30  rolled-up, or wrapped about arms  222 ,  224 . In this position, first and second ends  232 ,  234  of cinch cord  230  extend from either end of loop  34  of specimen retrieval bag  30  proximally therefrom. More specifically, as mentioned above, first end  232  of cinch cord  230  is looped about second end  234  thereof and is knotted to itself (see  FIG. 23 ), while second end  234  of cinch cord  230  extends through shaft  200 , ultimately engaging pull-ring  280 , e.g., passing through an aperture  284  defined within pull-ring  280  and knotting on a proximal side thereof. Pull-ring  280  is initially engaged within plunger assembly  260  and, thus, cinch cord  230  is relatively un-tensioned. More particularly, pull-ring  280  is retained within recessed proximal portion  272  of plunger assembly  260  via resilient lock tabs  274 . 
     In preparation for use, and with surgical retrieval apparatus  10  disposed in the retracted position, safety tab  140  is removed, thus permitting advancement of shaft  200  from the retracted position to the deployed position. Next, as shown in  FIGS. 18-19 , surgical retrieval apparatus  10 , lead by elongated sleeve  120 , is inserted through thoracic access portal  300  positioned within an incision “I” in tissue “T” between adjacent ribs “R” of a patient, although surgical retrieval apparatus  10  may be directly inserted through the incision “I,” or may be used in conjunction with any other suitable thoracic access portal (not shown). As can be appreciated, in this retracted position, since end effector assembly  220  does not extend from elongated sleeve  120 , surgical retrieval apparatus  10  defines a reduced diameter to facilitate passage of elongated sleeve  120  through access portal  300 , between adjacent ribs “R” of the patient, and into the internal surgical site, e.g., the thoracic cavity “C.” 
     With reference now to  FIGS. 18-23 , once surgical retrieval apparatus  10  has been inserted into the internal surgical site “C,” e.g., the thoracic cavity, shaft  200  may be translated distally through lumen  122 , e.g., via grasping handle  100  and plunger assembly  260  and translating plunger assembly  260  distally relative to handle  100 , from the retracted position to the deployed position such that end effector assembly  220  is extended from elongated sleeve  120 , to deploy arms  222 ,  224 , and specimen retrieval bag  30 . More specifically, shaft  200  is translated distally through lumen  122  until end effector assembly  220  extends distally from elongated sleeve  120 . 
     As can be appreciated, as end effector assembly  220  emerges from elongated sleeve  120 , specimen retrieval bag  30  is deployed, or unrolled, to the open condition, as shown in  FIGS. 22-23 . More specifically, the bias of support member  40  disposed within specimen retrieval bag  30  and the biasing of arms  222 ,  224  of end effector assembly  220  towards the spaced-apart, curvate configuration automatically transition specimen retrieval bag  30  to the open condition, wherein specimen retrieval bag  30  depends from aims  222 ,  224  of end effector assembly  220 , upon deployment from elongated sleeve  120 . Further, first and second ends  232 ,  234  of cinch cord  230  extend from specimen retrieval bag  30  in a substantially un-tensioned condition due to the maintained engagement of pull-ring  280  within plunger assembly  260  (see  FIGS. 16-17 ), thus maintaining specimen retrieval bag  30  in the open condition. 
     Continuing with reference to  FIGS. 18-23  and to  FIGS. 20-21  in particular, at this point, with end effector assembly  220  of surgical retrieval apparatus  10  disposed within the internal surgical site “C” in the deployed condition, end effector assembly  220  remains disposed in an unarticulated position, substantially aligned with longitudinal axis “X-X.” However, upon translation of shaft  200  to the deployed position, articulation post  258  is translated distally along longitudinal portion  132  of articulation track  130  defined within handle  100  from proximal end  133  thereof to distal end  135  thereof, wherein articulation post  258  is positioned adjacent helical portion  136  of articulation track  130 . Thus, once the deployed position has been achieved, end effector assembly  220  may be articulated to a desired position, or orientation, within the internal surgical site “C,” as will be described in greater detail below. 
     Referring now to  FIGS. 24-29 , in order to better position specimen retrieval bag  30  within the internal body cavity “C,” end effector assembly  220  may be articulated off of longitudinal axis “X-X” to facilitate capturing of the specimen of tissue “S” within surgical retrieval bag  30 . Surgical retrieval apparatus  10  may then be manipulated and/or additional surgical instrumentation (e.g., a surgical grasper (not shown)) may be used to position the specimen of tissue “S” within specimen retrieval bag  30 . 
     In order to articulate end effector assembly  220  and, thus, specimen retrieval bag  30 , the clinician grasps handle  100  with one hand and plunger assembly  260  of shaft  200  with the other hand and rotates handle  100  relative to shaft  200  about longitudinal axis “X-X” in a first direction, e.g., a counterclockwise direction. Rotation of handle  100  relative to shaft  200  effects likewise rotation of handle  100  relative to articulation bar  254  and articulation post  258 . Accordingly, as handle  100  is rotated about longitudinal axis “X-X” in the counterclockwise direction relative to articulation post  258 , articulation post  258  is translated into helical portion  136  of articulation track  130 . Helical portion  136  of articulation track  130  is pitched such that, as articulation post  258  is translated therethrough upon rotation of handle  100 , articulation post  258  is urged proximally, thereby translating articulation bar  254  proximally along recess  206  and relative to shaft  200 . Proximal translation of articulation bar  254 , in turn, pulls articulation linkage  250  proximally which urges arms  222 ,  224  of end effector assembly  220  to pivot about second pin  248  relative to shaft  200 , thereby articulating end effector assembly  220  off of longitudinal axis “X-X.” As can be appreciated, rotation of handle  100  in the opposite direction, e.g., the clockwise direction, translates articulation bar  254  distally, thereby articulating end effector assembly  220  back towards longitudinal axis “X-X.” With end effector assembly  220  articulated to the desired position, e.g., the position shown in  FIG. 29 , the specimen of tissue “S” can then be moved into specimen retrieval bag  30 . 
     Referring now to  FIGS. 29-31 , once the specimen of tissue “S” is disposed within specimen retrieval bag  30 , specimen retrieval bag  30  may be cinched closed and removed from the internal body cavity “C.” In order to cinch closed specimen retrieval bag  30  to secure the specimen of tissue “S” therein, end effector assembly  220  is first returned to the un-articulated position, e.g., via rotating handle  100  relative to shaft  200  in the opposite, e.g. clockwise direction. 
     Once end effector assembly  220  is aligned with longitudinal axis “X-X,” i.e., once end effector assembly  220  is returned to the unarticulated position, plunger assembly  260  is pulled proximally relative to handle  100  from the deployed position back to the retracted position. More specifically, the clinician grasps finger holes  114  of wings  112  of handle  100  with one hand, grasps flanges  268  of plunger assembly  260  with the other hand, and translate plunger assembly  260  and, thus, shaft  200  distally relative to handle  100 . Distal translation of shaft  200  relative to handle  100  and elongated sleeve  120  translates arms  222 ,  224  of end effector assembly  220  proximally into lumen  122  of elongated sleeve  120  and likewise translates cinch cord  230  proximally therethrough to at least partially cinch-closed specimen retrieval bag  30 . As shaft  200  is translated distally, arms  222 ,  224  of end effector assembly  220  are urged toward one another to be accommodated within lumen  122  of sleeve  120  and are withdrawn from loop  34  of specimen retrieval bag  30 , thus disengaging specimen retrieval bag  30  from end effector assembly  220 , leaving specimen retrieval bag  30  disposed externally and distally of elongated sleeve  120 . Further, due to the proximal translation of shaft  200  and, thus cinch cord  230  relative to specimen retrieval bag  30 , specimen retrieval bag  30  is at least partially cinched closed as shaft  200  is moved to the retracted position. 
     Turning now to  FIGS. 32-34 , in order to fully cinch-closed specimen retrieval bag  30 , pull-ring  280  is disengaged from plunger assembly  260  and is translated proximally relative thereto such that second end  234  of cinch cord  230  is translated proximally relative to specimen retrieval bag  30 . More specifically, the clinician inserts one or more fingers through opening  286  defined through pull-ring  280  and into recessed rim  272  of plunger assembly  260  to grasp inwardly-extending lip  282  of pull-ring  280 . The clinician then translates pull-ring  280  distally with sufficient urging to disengage pull-ring  280  from resilient lock tabs  274  such that pull-ring  280  may be translated proximally with respect to plunger assembly  260  and, thus, shaft  200 . As mentioned above, second end  234  of cinch cord  230  is disposed through aperture  284  ( FIG. 16 ) of pull-ring  280  and is knotted on a proximal side thereof such that translating pull-ring  280  relative to plunger assembly  260  translates cinch cord  230  proximally to fully cinch specimen retrieval bag  30  closed, as shown in  FIGS. 32-33 . 
     With reference now to  FIG. 34 , the looping of first end  232  of cinch cord  230  about second end  234  thereof retains cinch cord  230  in position, i.e., the looping of cinch cord  230  inhibits un-tensioning of cinch cord  230 , thereby maintaining specimen retrieval bag  30  in the cinched-closed condition. As such, once specimen retrieval bag  30  has been cinched closed with the specimen of tissue “S” disposed therein, cinch cord  230  may be cut to release cinch cord  230  and specimen retrieval bag  30  from the remainder of surgical retrieval apparatus  10 , i.e., handle  100 , elongated sleeve  120  and shaft  200 . These other components of surgical retrieval apparatus  10  may then be removed from the internal surgical site “C” through access portal  300 , leaving behind specimen retrieval bag  30 , which is disposed in the closed condition with the specimen of tissue “S” therein, and cinch cord  230 , which extends from specimen retrieval bag  30  to the second, cut end  234  thereof. More specifically, cinch cord  230  is cut to disengage second end  234  of cinch cord  230  from pull-ring  280 , allowing cinch cord  230  to pass through handle  100 , elongated sleeve  120 , and shaft  200  as these components are withdrawn from the internal surgical site “C,” such that specimen retrieval bag  30  and cinch cord  230  remain disposed within the internal surgical site “C.” Ultimately, the cut end  234  of cinch cord  230  is translated proximally to remove specimen retrieval bag  30  and the specimen of tissue “S” disposed therein from the internal surgical site “C.” 
     Turning now to  FIGS. 35-37 , another embodiment of a surgical retrieval apparatus, similar to surgical retrieval apparatus  10  ( FIGS. 1-34 ), provided in accordance with the present disclosure is shown generally identified by reference numeral  15 . Surgical retrieval apparatus  15  generally includes a handle  400  having an elongated sleeve  420  fixedly engaged thereto and extending distally therefrom, a shaft  500  having an end effector assembly  520  disposed at a distal end  502  thereof, an articulation assembly  540  coupled thereto, and a plunger assembly  560  disposed at a proximal end  504  thereof. Surgical retrieval apparatus  15  is substantially similar to surgical retrieval apparatus  10  ( FIGS. 1-25 ) in both configuration and operation, except for the configuration of handle  400  and plunger assembly  560 . Thus, only the differences between surgical retrieval apparatus  15  and surgical retrieval apparatus  10  ( FIGS. 1-25 ) will be described in detail hereinbelow to avoid unnecessary repetition. 
     Handle  400  of surgical retrieval apparatus  15  includes a pair of opposed housing members  402 ,  404  interconnected by a cylindrical tube  406 . Housing members  402 ,  404  each define a generally-annular configuration having a plurality of flanges  403 ,  405 , respectively, extending radially outwardly therefrom. Flanges  403  are spaced-apart from one another, as are flanges  405 , to define a plurality of finger recesses  407  therebetween. Finger recesses  407  facilitate grasping and rotation of handle  400  about longitudinal axis “X-X” relative to shaft  500  in order to articulate end effector assembly  520  and specimen retrieval bag  30  relative to longitudinal axis “X-X.” The use and operation of handle  400  is substantially similar to that of handle  100  of surgical retrieval apparatus  10  ( FIGS. 1-34 ). 
     Plunger  560  of surgical retrieval apparatus  15  is fixedly engaged to proximal end  504  of shaft  500 , e.g., via pin  564 , and includes a base  561  and a proximal hub  562  extending proximally from base  561 . Proximal hub  562  defines a generally-hemispherical configuration wherein the rounded surface  565  thereof faces proximally. Further, proximal hub  562  includes a tab  566  extending from proximal, rounded surface  565  thereof that is configured to releasably retain second end  234  of cinch cord  230  therein. As such, rather than providing a pull-member for securing second end  234  of cinch cord  230  thereto, surgical retrieval apparatus  15  retains second end  234  of cinch cord  230  thereon by engagement within tab  566 . Accordingly, when it is desired to retract cinch cord  230  relative to plunger  560  to fully cinch closed specimen retrieval bag  30 , second end  234  of cinch cord  230  is disengaged from tab  566  and is translated proximally. The use and operation of surgical retrieval apparatus  15  is otherwise substantially similar to that of surgical retrieval apparatus  10 , discussed above with respect to  FIGS. 1-34 , and, thus will not be repeated here. 
     Turning now to  FIGS. 38-39 , another embodiment of a surgical retrieval apparatus  20  provided in accordance with the present disclosure is shown. Surgical retrieval apparatus  20  is substantially similar to similar to surgical retrieval apparatus  15  ( FIGS. 35-37 ) except for the configuration of handle  600 . Accordingly, only handle  600  will be described hereinbelow for purposes of brevity. 
     Handle  600  of surgical retrieval apparatus  20  includes a generally-cylindrical body  602  having a plurality of flanges  604  extending radially outwardly therefrom. Flanges  604  taper distally to proximally and are spaced-apart from one another to define a plurality of finger recesses  606  therebetween that facilitate grasping and rotation of handle  600 . Proximal end  608  of handle  600 , including the distal ends flanges  604 , defines a relatively planar surface extending generally perpendicularly to longitudinal axis “X-X” which may be configured to mate with the planar distal surface  668  of the generally-hemispherical proximal hub  664  of plunger  660 . Such a configuration inhibits catching of plunger  660  on the clinician&#39;s clothing, interference with other surgical instrumentation, and/or inadvertent movement of shaft  700  relative to handle  600  and elongated sleeve  620 . 
     From the foregoing and with reference to the various figure drawings, those skilled in the art will appreciate that certain modifications can also 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.