Robert Gorter observed and documented himself several operations under acupuncture anesthesia and he made sure he could confirm that patients were alert and in no obvious distress. All pictures were made by Robert Gorter.
Dr. Gorter had made the same experience with abdominal surgeries as Chinese surgeons during their operations: the only tissue what stays sensitive and seems to be difficult to influence is the peritoneum. Therefore, when cutting the peritoneum, an infiltration with a local anesthetic (Lidocaine or Procaine) was used. Also, one would not pull too hard on the organs as this can provoke a Vagus reflex.