A soft dual-port trocar for endoscopic subcutaneous surgery

Background: We developed a new trocar for endoscopic subcutaneous surgery a nd tested it in subfascial endoscopic perforator surgery (SEPS) for varicos e veins of the lower leg. Methods: The soft trocar is a Y-shaped polyvinyl chloride bag equipped with two ports at one end and a flexible ring at the other end. We performed SE PS on 12 patients through a 2-cm incision below the knee. After dissection of the subfascial plane, the ring of the trocar was inserted beneath the fa scia, and the subfascial cavity was inflated with CO2 gas, The perforating veins were divided with UltraShears (Autosuture, USSC, Norwalk, CT, USA) in serted through the second port of the trocar with an endoscope. Results: There were no major device-related difficulties or wound complicat ions. Conclusion: The soft trocar allowed both an endoscope and a surgical instru ment to be inserted simultaneously in the tissue space through a single inc ision. This useful instrument may have applications in other endoscopic sur gical procedures.