NITI-ON
BJ Needle

Owing to its cosmetic advantages over conventional laparoscopic surgeries, single-incision laparoscopic procedures, introduced in 2008, gained enormous popularity in Japan. Despite its irrefutable benefits, the trend didn’t last long. “The ergonomics in a single incision operation was appalling since it sacrificed the most important essence of surgery—manipulation angle—and adversely affected the quality of operations. The procedures prolonged operation times and stressed the surgeons,” recalls Dr. Eiji Kanehira. Convinced that the poor ergonomics resulted in lower sustainability, Dr. Kanehira collaborated with Hiroshi Honda, CEO, and president of NITI-ON, a Japan-based manufacturer of cleaning, sterilization, endoscopic and surgical instruments, to improve the efficiency of single-incision surgeries. Together, they added a two-millimeter access port to the single incision instruments that were more rigid, durable, and easily maneuverable. The novel ‘single-incision plus one puncture’ method was substantially faster, safer, ergonomic, and more aesthetic. NITI-ON has been at the forefront of improving the landscape of hospital setting providers in Japan with its three pillars of operations—reprocessing surgical devices, infection control, and surgical instrumentation.

NITI-ON was established a century ago by Masataka Honda in Tokyo, Japan as a manufacturer of otolaryngology steel medical instruments. Since then, the company has embraced the ideology of Japanese essayist Sei Shōnagon, “All things small are beautiful,” and pushed boundaries of innovation in the development of minimally invasive surgical instruments and techniques. The company manufactures its instruments by following two of Japan’s ancient craftsmanship and blacksmith practices—Karakuri, Japanese mechanized puppets, and Kanzashi, making hair ornaments using folded cloth. Geared around its vision of challenging the impossible, NITI-ON’s instruments are of the highest caliber, superseding conventional procedures and inspiring surgeons to re-evaluate their approach towards patient care. Its BJ Instrument series is helping medical professionals create new value and improve the efficiency of laparoscopic surgeries.

“Unlike conventional endoscopic instruments, our BJ needles reduce the number and size of incisions required during laparoscopic surgeries and lessens physical stress on patients by ensuring minimal invasiveness and damage to the body,” elaborates Honda. NITI-ON’s 2mm forceps provide the equivalent rigidity of commercially available 3mm forceps. Honda’s visit to a Porsche factory was the impetus for BJ needle’s shaft rotation functionality and enormous maneuverability.

The instrument has demonstrated its durability on several occasions, where surgeons utilized the needle to carry out over 450 operations without any breakage. To illustrate BJ needle’s great practicality, Mr. Honda cites a success story where Dr. Eiji Kanehira performed operations using the instrument.

Dr. Kanehira has employed NITI-ON’s BJ needle while performing several cystectomies and single-incision procedures. After moving to another hospital, he and his team have performed over a thousand laparoscopic cholecystectomies with a 93% success rate. Dr. Kanehira also reported favorable operative outcomes with acceptably smaller numbers of complications when compared to pure, single-incision procedures performed by other hospitals. “Considering its user-friendliness, the BJ needle can be easily transferred to novice surgeons within a couple of months,” extols Honda.

NITI-ON has scripted similar success stories where surgeons could safely complete single-port surgeries by puncturing a 2mm single-incision on the side of patients’ bodies using BJ instruments. Today, this equipment is used in various surgeries, such as hemicolectomy, wedge resection of the stomach, intragastric surgery, and splenectomy. NITI-ON has addressed issues related to the research, development, and practical applications of minimally invasive instruments with its proprietary technologies. Looking ahead, the company is motivated to proactively resolve the emerging challenges in APAC’s medtech ecosystem.



NITI-ON is currently engaged in the productization of double bendable forceps with artificial muscle mechanisms. The sheer speed and scale at which its innovative surgical instruments enable surgeons to perform surgeries is genuinely remarkable and goes on to showcase NITI-ON’s commitment to improving medical services and becoming the De facto standard in APAC’s medtech industry. “Global communities are constantly changing. The medical industry also needs to evolve to accommodate those changes and serve patients better. Going forward, NITI-ON aims to achieve sustainable growth by enhancing its capabilities in the development of robotassisted surgical instruments and product design, as well as by expanding its portfolio of distinctive products,” concludes Honda.