{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:29:48Z","timestamp":1791822588016,"version":"4.3.4"},"reference-count":25,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T00:00:00Z","timestamp":1768435200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objective: To evaluate the extent of intraoperative bacterial and tumour cell spillage during minimally invasive colorectal surgery and to assess the protective value of systematic specimen retrieval using a tear-proof extraction bag. Methods: This multicentre, prospective observational study included patients undergoing conventional or single-port laparoscopic colorectal surgery for adenocarcinoma, premalignant polyps, or chronic diverticulitis. Three intraoperative samples were obtained for microbiological and cytological analysis: after pneumoperitoneum induction (sample 1), after vascular ligation and bowel division (sample 2), and after specimen extraction using a retrieval bag (sample 3). Results: Eighty-eight patients were included. Bacterial contamination increased significantly throughout the procedure occurring in 11.4% of sample 1, 37.5% of sample 2, and 67% of sample 3 (p &lt; 0.001). When sample 1 was positive, sample 2 was positive in 100% of cases; when sample 2 was positive, sample 3 was positive in 79% of cases. In 33 patients (37.5%), bacterial growth was detected exclusively in sample 3. Contamination in sample 2 was significantly associated with surgical approach (p = 0.013), anastomotic technique (p = 0.022), and malignant disease (p = 0.038). A longer hospital stay was significantly associated with contamination in samples 1 and 2 (p = 0.014 and p &lt; 0.001, respectively). No tumour cells were detected in any sample, except for one case showing atypical cells without clinical relevance in sample 3. Conclusions: Intraoperative bacterial contamination progressively increases during minimally invasive colorectal surgery, peaking after specimen extraction. Most clinical and surgical variables did not significantly influence contamination rates. The use of a specimen retrieval bag demonstrated a potential protective effect by containing bacterial spillage. However, no protective effect regarding tumour cell dissemination could be demonstrated based on cytology analysis.<\/jats:p>","DOI":"10.3390\/jcm15020726","type":"journal-article","created":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T16:21:13Z","timestamp":1768494073000},"page":"726","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Evaluating the Role of Retrieval Bags in Mitigating Contamination During Minimally Invasive Colorectal Surgery"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0837-8986","authenticated-orcid":false,"given":"Javier","family":"Valdes-Hernandez","sequence":"first","affiliation":[{"name":"Department of General and Digestive Surgery, University Hospital Virgen Macarena, University of Sevilla, 41009 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0182-8761","authenticated-orcid":false,"given":"Andrea","family":"Balla","sequence":"additional","affiliation":[{"name":"Department of General and Digestive Surgery, University Hospital Virgen Macarena, University of Sevilla, 41009 Sevilla, Spain"},{"name":"Unit of General and Digestive Surgery, Hospital Quir\u00f3nsalud Sagrado Coraz\u00f3n, 41013 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1928-1231","authenticated-orcid":false,"given":"Christof","family":"Mittermair","sequence":"additional","affiliation":[{"name":"Department of General and Visceral Surgery, Saint John of God Hospital, Teaching Hospital of the Paracelsus Medical University Salzburg, Kajetanerplatz 1, 5010 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2335-3779","authenticated-orcid":false,"given":"Christian","family":"Obrist","sequence":"additional","affiliation":[{"name":"Department of General and Visceral Surgery, Saint John of God Hospital, Teaching Hospital of the Paracelsus Medical University Salzburg, Kajetanerplatz 1, 5010 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9467-1934","authenticated-orcid":false,"given":"Juan Carlos","family":"G\u00f3mez-Rosado","sequence":"additional","affiliation":[{"name":"Department of General and Digestive Surgery, University Hospital Virgen Macarena, University of Sevilla, 41009 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Pimpl","sequence":"additional","affiliation":[{"name":"Department of General and Visceral Surgery, Saint John of God Hospital, Teaching Hospital of the Paracelsus Medical University Salzburg, Kajetanerplatz 1, 5010 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7022-1739","authenticated-orcid":false,"given":"Eberhard","family":"Brunner","sequence":"additional","affiliation":[{"name":"Department of General and Visceral Surgery, Saint John of God Hospital, Teaching Hospital of the Paracelsus Medical University Salzburg, Kajetanerplatz 1, 5010 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5959-8252","authenticated-orcid":false,"given":"Jan","family":"Schirnhofer","sequence":"additional","affiliation":[{"name":"Department of General and Visceral Surgery, Saint John of God Hospital, Teaching Hospital of the Paracelsus Medical University Salzburg, Kajetanerplatz 1, 5010 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3808-7220","authenticated-orcid":false,"given":"Helmut","family":"Weiss","sequence":"additional","affiliation":[{"name":"Department of General and Visceral Surgery, Saint John of God Hospital, Teaching Hospital of the Paracelsus Medical University Salzburg, Kajetanerplatz 1, 5010 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2833-0717","authenticated-orcid":false,"given":"Salvador","family":"Morales-Conde","sequence":"additional","affiliation":[{"name":"Department of General and Digestive Surgery, University Hospital Virgen Macarena, University of Sevilla, 41009 Sevilla, Spain"},{"name":"Unit of General and Digestive Surgery, Hospital Quir\u00f3nsalud Sagrado Coraz\u00f3n, 41013 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e2022.00039","DOI":"10.4293\/JSLS.2022.00039","article-title":"Extracorporeal Hand-Sewn vs. Intracorporeal Mechanic Anastomosis During Laparoscopic Right Colectomy","volume":"26","author":"Lepiane","year":"2022","journal-title":"J. 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