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
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