Secured independent tools in peritoneoscopy

Background and Objectives: Secured independent tools are being introduced to aid in peritoneoscopy. We present a simple technique for anchoring instruments, powered lights, and micro machines through the abdominal wall. Methods: We used a laparoscopic trainer, micro alligator clips with one or two 2-0 nylon tails and cables for engines and lights. The above instruments were introduced via a 12-mm or 15-mm port. Clips were placed for traction, retraction and exposure, lights for illumination, and motors for potential work. A laparoscopy port closure or suture passer was introduced percutaneously to grab and extract the tails or cables outside of the simulated abdominal cavity. The engines and lights were powered by a direct electric current (DC) plugged into exteriorized cables. Results: We used 2 to 3 clips for each, and engines performed well. Conclusion: This basic simulation adds independent instruments, lights, and engines. We replaced cannulas with threads or cables in an attempt to limit the number of ports. This technique further opens the door for innovations in wired machines in laparoscopy, single-port laparoscopy, or natural orifice surgery.