In endoscopic surgery, the use of long surgical instruments through access ports diminishes tactile feedback and degrades the surgeon's ability to identify hidden tissue abnormalities. To overcome this constraint, we developed a real-time compliance mapping system that is composed of: 1) a standard surgical instrument with a high-precision sensor configuration design; 2) real-time objective interpretation of the output signals for tissue identification; and 3) a novel human-computer interaction technique using interactive voice and handle force monitoring techniques to suit operating theater working environment. The system was calibrated and used in clinical practice in four routine endoscopic human procedures. In a laboratory-based experiment to compare the tissue discriminatory power of the system with that of surgeons' hands, the system's tissue discriminatory power was three times more sensitive and 10% less specific. The data acquisition precision was tested using principal component analysis (R(2)X = 0.975, Q2 [cumulative (cum)] = 0.808 ) and partial least square discriminate analysis (R(2)X = 0.903, R(2)Y = 0.729, Q2 (cum) = 0.572).