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Abstract

A method for use in intra-abdominal surgery comprises the steps of inserting a tubular member into a natural body cavity of a patient through a natural body opening, manipulating the tubular member from outside the patient so that a distal end of the tubular member engages a wall of the natural body cavity, and forming a fluid tight connection between the distal end of the tubular member and the wall. Additional steps of the method include inserting an incising instrument through the tubular member upon insufflation of the abdominal cavity, manipulating the incising instrument from outside the patient to form a perforation through the surface of the wall, and moving a distal end of an endoscope through the tubular member and through the perforation. The endoscope is used to visually inspect internal body tissues in an abdominal cavity of the patient. Subsequently, a surgical operation is executed on the internal body tissues of the patient by manipulating an endoscopic surgical instrument passed along the endoscope through the natural body opening, the natural body cavity and the perforation into the abdominal cavity. After the intra-abdominal operation, the surgical instrument and the endoscope are withdrawn from the abdominal cavity through the perforation, the perforation is closed, and the endoscope and the tubular member are withdrawn from the natural body cavity.

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