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結紮手技を省略できるsuture clip & applier(LAPRATY®:エチコン エンドサージェリー)を使用し,十二指腸潰瘍穿孔部の大網被覆術および充填術を4例に施行し,短時間に,また簡単に穿孔部閉鎖が行えたので手技を中心に報告する.LAPRATY®使用による利点は,(1)穿孔部の大きさにかかわらず大網の被覆,充填いずれの方法も選択できる,また被覆範囲,充填大網量が自由に設定できること,(2)結紮手技が必要ないため,術者1人で短時間に,簡単に閉鎖可能なこと,である.LAPRATY®は,内視鏡下外科領域における種々の縫合,閉鎖手技に応用でき,有用と思われる.
On four cases with perforated duodenal ulcers, we have recently performed omental covering or sealing operations with the use of a suture clip and applier (LAPRATY®: ETHICON ENDO-SURGERY), simplifying the ligature procedure. With this method, perforations could easily and quickly be closed. We hereby report this treatment focusing on its technique. The use of LAPRATY offers the following advantages : the covering or sealing can be selected regardless of the perforation size and, the area to be covered or the amount of omentum necessary for sealing can be selected adequately.
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