Pinoko serves as Black Jack's sidekick. She is a little girl constructed by him, but she is actually a Teratogenous Cystoma, a type of tumor also known as a teratoma. As shown in the story Teratogenous Cystoma, she was a rare kind of Siamese twin who lived inside one of Black Jack's patients' bodies for eighteen years. Black Jack extracted her and gave her a real body, which is a plastic exo-skeleton. After her twin sister rejected her, she began living with Black Jack in his house. She always helps the doctor by doing housework and even acting as an assistant during some of his operations. She often provides comic relief in Black Jack; physically and mentally, she appears to be around five years old, yet she claims to be an eighteen-year-old girl engaged to him, even though he only treats her as a daughter.
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