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Introduction/Background Laparoscopic surgery has become widely accepted in oncology, but concerns regarding tumor spillage persist. This video article addresses the issue of intraoperative tumor spillage and presents a 'no-touch' containment technique to mitigate this risk. Methodology The patient, a 74-year-old female with a history of stage 3A ovarian carcinosarcoma and somatic BRCA-1 mutation, underwent minimally invasive secondary cytoreductive surgery for a local recurrence. The 'no-touch' containment technique was employed, involving extensive dissection of surrounding tissue to access the tumor base, minimizing the need for direct tumor manipulation. When manipulation was necessary, a sterile X-ray detectable cotton sponge was used to grasp the tumor without contacting its surface. Results The procedure was successful with an estimated blood loss of 50 mL and no complications. The patient was discharged on postoperative day 0. Histologic evaluation confirmed a poorly differentiated carcinoma consistent with the previous ovarian carcinosarcoma. The 'no-touch' containment technique demonstrated feasibility in removing local recurrences, highlighting its potential in preventing tumor spillage. Conclusion This video article emphasizes the importance of adopting a 'no-touch' containment technique during minimally invasive surgeries to reduce the risk of tumor spillage and peritoneal dissemination. By adhering to principles of accessing the tumor base through extensive dissection and using a cotton sponge for manipulation while avoiding direct contact, surgeons can enhance oncologic safety. Disclosures Nothing to disclose.
Erfani et al. (Fri,) studied this question.