Preliminary report of multi degrees of freedom forceps for endoscopic surgery.

Laparoscopic suturing requires more complex techniques than conventional open surgery, because of the limited degrees of freedom of endoscopic devices. The prototype multi degrees of freedom forceps was developed with a concept of a flexibility that frees us from the restriction on suturing during endoscopic surgery. It was designed for a needle holder. We calculated the movement of the forceps' distal joint at the time of horizontal suturing. The learning curve was also investigated for ten surgeons. The device was clinically applied in several surgeries. We could perform suturing freely using this prototype forceps at any point and in any directions. The learning curve had its peak within five training sessions, and may be mastered during about ten training sessions. All clinical applications were successfully achieved. With the increased degree of freedom for forceps, the operability for endoscopic surgery was improved.