The Innovative Safe and sterile Sigmoid Approach (ISSA) was developed to establish the instruments and the technique for a transsigmodial access in minimally invasive surgery to support endoscopic interventions. Especially for Natural Orifice Transluminal Endoscopic Surgery (NOTES), the transcolonic approach offers relevant advantages compared with a transgastric procedure. The developed instrument set, including a special trocar, is now manufactured by Storz. The ISSA avoids bacterial contamination and provides the possibility to occlude of the incision securely. Design and shape are adapted to the human pelvis. A multimodal assembly offers adequate support at the different intervention steps. Further a composition for gas tightness that still offers flexible handling of the endoscope and the instruments was integrated.