INTRODUCTION: It is described in medical documents that Needlescopic Surgery by use of 3-mm diameter forceps is a minimally invasive surgery method which does not damage somatic pain nerves on the body surface. However, when we deal with bigger organs to be operated such as in gastrectomy or hepatectomy, we are faced with the problem of incapability of delivering the resected segment. To make it possible to resect bigger organs, we invented a new surgery method, Multi Piercing Surgery (MPS), where all operation is carried out by 3-mm diameter devices for Needlescopic Surgery and only two tasks of ensuring visual field and delivering the resected organ segments are performed through the perforator of rectal wall, which does not have somatic pain nerves.
Regarding the 3-mm device for the surgery, we used electronic control forceps whose performance can be regulated by a surgeon with his tactile sense under the antisepsis environment before the operation so that we could omit injuries by puncture and crush due to the smallness of the device diameter, and we removed the risk of small diameter forceps basically.
METHODS: We carried out the test using 5 pigs. We conducted gastrectomy and hepatectomy, using two 3-mm diameter electronic control forceps from its body surface. We induced and used a 10-mm diameter flexible laparoscope through the rectal wall opening upon identifying the peritoneal reflection of rectum by use of 5-mm small diameter ultrasonic waves. To prevent the opening of rectum from getting injured while delivering the organ out of rectum, we used a device to make the opening of rectum completely round. We carried out the 60-mm diameter all layer resection out of the gastric body and the 60-mm longest-diameter resection of the lateral segment of liver. The resected specimens were delivered out of the body using a 5-mm diameter end-catch through the rectal wall opening. Closing of the export opening of rectum was carried out using an end-cutter.
RESULTS: It was possible to conduct gastrectomy and hepatectomy within 2 hours without any complications. Safe and efficient surgical procedure is achieved by using electronic control forceps. Its tip takes appropriate positions immediately, which cannot be performed when operated manually.
CONCLUSION: Multi Piercing Surgery using electronic control forceps is considered to have high potential to be a minimally invasive and efficient operative procedure.
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