Fig. 1

Photograph and schematic diagram of the gasless laparoscopic surgery (GLS) using the subcutaneous abdominal wall lifting (SAWL) procedure. The photograph shows the surgeon inserting two forceps from the lap protector to perform surgery. The assistant controls the camera and grasps the tissue with the forceps. The schematic shows the location of lifting equipment, Lap Protectors, and ports. The Lap Protector is usually the smallest Tokyo Medical University (TMU) type. This corresponds to a port size of 10–20 mm. In addition, for obese cases with a thick abdominal wall, a tall ultra mini type is used