腹腔鏡下手術における新しい持針器

Development of an original needle holder for laparoscopic surgery involving abdominal wall-lift.

　吊り上げ式腹腔鏡下手術の縫合に用いる新型持針器を試作し，臨床に応用した，通常の開腹手術に用いている持針器の形状に近いため，操作時の違和感がなく丁寧な縫合操作が可能であった．ソフトタイプトロッカーを通して使用することで径12mmのポートでも良好な操作性が得られた．本手技の適応範囲は広いと考えられるが，なかでも総胆管切開時の胆管縫合には有用であると考えられた．

We have developed a new original needle holder and applicated it in laparoscopic surgery with abdominal wall-lift. It is possible to make a fine-textured suture without awkward feeling because the needle holder resembles the conventional one use in open surgery in shape. When the needle holder is used through the soft type trocar, we can get a very good control of it even though the trocar is 12 mm in diameter. This technique is considered it possible to be applicated to various suturing procedure, especially to get great advantages in suturing choledochal wall after choledochotomy.