Developing essential rigid-flexible outer sheath to enable novel multi-piercing surgery

Abstract

We have developed a new generation device called rigid-flexible outer sheath with multi-piercing surgery (MPS) to solve the issues of tissue closure, triangulation, and platform stability in natural orifice transluminal endoscopic surgery (NOTES), and the problems of restricted visual field, organ damage, and removing a resected organ from body in needlescopic surgery (NS). The shape of the flexible outer sheath can be selectively locked by a novel pneumatic shapelocking mechanism. Major features include four directional flexion at the distal end, four working channels, and suction and water jet functions. The insertion part of the prototype is 330 mm long with a 25 mm maximum outer diameter. The outer sheath system has successfully preformed in vivo experiment using a swine on partial gastrectomy. The advanced outer sheath system has shown great promise for solving NOTES and NS issues.