The second adaptation of the PSSST is designed specifically for ligation of bleeding superior and inferior epigastric arteries damaged at the port site. The most common port causing such damage is a 5mm port. Therefore the second adaptation of the PSSST has a narrow distal end which lies in the rectus muscle layer but the suture carrying needle exits from the wider part of the PSSST superficial to the rectus muscle, thus increasing the ‘bite’ of rectus muscle and artery included in the suture to be sure of encompassing the bleeding artery.

The drawing for the second adaptation can be downloaded using this link.