Usefulness of a Flexible Port for Natural Orifice Transluminal Endoscopic Surgery by the Transrectal and Transvaginal Routes
(a) A scene in which the device for conventional laparoscope-assisted surgery is used via the flexible port: a scene, in which 5 mm LigaSure and 5 mm grasping forceps are inserted from the anus into the abdominal cavity and are used, is shown (A) and (B). It is possible to conduct surgery according to the cross and parallel methods (C) and (D) similarly to SPS. (b) Single arrow: the apex of the 10 mm endoscope was inserted through the flexible port of 12 mm in diameter. The double arrow: the head of LigaSure which was inserted through the flexible port of 12 mm in diameter. (c) Full-thickness gastrectomy which was conducted with the flexible port: (A) the head of LigaSure of 10 mm in diameter which was inserted into the abdominal cavity through the flexible port. LigaSure of 10 mm in diameter made it possible to treat the great omentum and mobilize the stomach. (B) Full-thickness gastrectomy using Harmonic Scalpel: it was necessary to pull the stomach toward the tail with 45 cm grasping forceps in order to conduct full-thickness gastrectomy. (C) A scene indicating the completion of full-thickness partial resection of the stomach dummy lesion.(D) Closure of the gastric incision with a needle holder: when inserting a needle into the abdominal cavity through the flexible port, an ordinary needle is curved in the form of ski before use. A magnetic traction device developed by Ohdaira is used as the auxiliary device for resection.
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