A soft dual-port trocar for endoscopic subcutaneous surgery

We developed a new trocar for endoscopic subcutaneous surgery and tested it in subfascial endoscopic perforator surgery (SEPS) for varicose veins of the lower leg.

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 SEPS 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 fascia, and the subfascial cavity was inflated with CO2 gas. The perforating veins were divided with UltraShears (Autosuture, USSC, Norwalk, CT, USA) inserted through the second port of the trocar with an endoscope.

There were no major device-related difficulties or wound complications.

The soft trocar allowed both an endoscope and a surgical instrument to be inserted simultaneously in the tissue space through a single incision. This useful instrument may have applications in other endoscopic surgical procedures.