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Figure 3: Direct insertion method of the Endo-Relief. The Shaft guide Plus (Hope Denshi Co., Chiba, Japan) is directly inserted into the abdominal cavity through the abdominal wall (a). The top of the guide is passed through a 5-mm port extra-corporeally, and the inner needle is removed (b). The forceps end (arrow) is connected to the shaft guide outer sheath (c). The handle parts are fi nally assembled, and the forceps top is intra-corporeally pulled through a 5-mm port (d)

Figure 3: Direct insertion method of the Endo-Relief<sup>™</sup>. The Shaft guide Plus<sup>™</sup> (Hope Denshi Co., Chiba, Japan) is directly inserted into the abdominal cavity through the abdominal wall (a). The top of the guide is passed through a 5-mm port extra-corporeally, and the inner needle is removed (b). The forceps end (arrow) is connected to the shaft guide outer sheath (c). The handle parts are fi nally assembled, and the forceps top is intra-corporeally pulled through a 5-mm port (d)