[Endoguide Reinbek--a device for trocarless insertion of instruments in endoscopic surgery]

The Endoguide Reinbek (EGR) is a device that allows the insertion and use of laparoscopic instruments without a trocar-sheath unit. It consists of a steel rod 40 cm long and 10 mm in diameter, with pointed ends that can be screwed off. One end is 10 mm in diameter and the other, 6 mm. Both points can be covered by a removable handle.

The EGR is introduced into the abdominal cavity via a 10-mm port. Camera supervision is applied to select the exact position for any instrument. The tip of the EGR perforates the abdominal wall from inside, thus preventing any damage to blood vessels of viscera. A small skin incision is made over the tip once the skin bulges outward at the body surface. Once outside the abdomen the tip is removed, leaving a socket into which any instrument, e.g. a forceps, fits. The instrument is "guided" into the abdominal cavity by simply pushing it axially to the EGR. Inside the abdomen the EGR is disconnected from the instrument and withdrawn. The instrument is used without a port. There is no more loss of gas than when trocars are used. The EGR is especially useful for instruments that do not have to be changed during the operation and for the application of endoscopic drains. However, instruments can also be changed. The main advantage of the EGR is cost reduction, especially if disposable trocars have been used thus far. If reusable trocars have been applied so far there is a significant reduction in the maintenance effort (dismanting, cleaning, reassembly and resterilization of trocars). Moreover, endoscopic instruments can be positioned more safely and more precisely.