EASY (endoscopic approach to the symphysis): a new minimally invasive approach for the plate osteosynthesis of the symphysis and the anterior pelvic ring—a cadaver study and first clinical results

  • Markus Alexander Küper
  • Alexander Trulson
  • Inga Maria Trulson
  • Christian Minarski
  • Leonard Grünwald
  • Christoph Gonser
  • Christian Bahrs
  • Bernhard Hirt
  • Ulrich Stöckle
  • Fabian Maria Stuby
Original Article



Minimally invasive surgical approaches to reduce approach-associated morbidity are an interdisciplinary goal in surgery. In principle, the endoscopic approach for the extraperitoneal repair of groin hernias is the minimally invasive variant of the modified Stoppa-approach, which is used for the treatment of pelvic ring injuries in traumatology.


Anatomical feasibility study regarding the plate osteosynthesis of the anterior pelvic ring via a minimally invasive variant of the modified Stoppa-approach.


We present the minimally invasive variant of the modified Stoppa-approach in a human cadaver step by step, both photographically and radiologically. Feasibility of the plate osteosynthesis of the symphysis is presented in a patient with open book injury via the minimally invasive approach using standard laparoscopic instruments.


The plate osteosynthesis of the anterior pelvic ring via the minimally invasive variant of the modified Stoppa-approach is feasible with existing standard laparoscopic instruments.


Symphysis Pelvic ring Plate osteosynthesis Stoppa-approach Minimally invasive surgery EASY-approach 



We thank Mrs. Catharina Scheuermann-Poley for editing this manuscript for the English language.

Compliance with ethical standards

Conflict of interest

Drs. Markus Alexander Küper, Alexander Trulson, Inga Maria Trulson, Christian Minarksi, Leonard Grünwald, Christoph Gonser, Christian Bahrs, Bernhard Hirt, Ulrich Stöckle and Fabian Maria Stuby have no conflicts of interest or financial ties to disclose.

Ethical approval

The cadaver studies were performed at the Institute of Clinical Anatomy and Cell. Analysis of the Eberhard Karls University in Tübingen, Germany. The rules of the Declaration of Helsinki were strictly followed throughout the cadaver study. The body donors approved the scientific usage of their bodies for teaching and research purposes in their lifetime and the local Ethics committee of the University of Tübingen approved the scientific usage. The patient approved the publication of his case including history of the accident, course of his in-patient treatment and surgical course with images of the operation situs and the postoperative scars as well as the fluoroscopic and radiological images.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Markus Alexander Küper
    • 1
  • Alexander Trulson
    • 1
  • Inga Maria Trulson
    • 1
  • Christian Minarski
    • 1
  • Leonard Grünwald
    • 1
  • Christoph Gonser
    • 1
  • Christian Bahrs
    • 1
  • Bernhard Hirt
    • 2
  • Ulrich Stöckle
    • 1
  • Fabian Maria Stuby
    • 1
  1. 1.BG Trauma Center, Department for Traumatology and Reconstructive SurgeryEberhard Karls University TübingenTübingenGermany
  2. 2.Institute of Clinical Anatomy and Cell AnalysisEberhard Karls University TübingenTübingenGermany

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