腹腔鏡下副腎・腎摘除術におけるハーモニック・スカルペルの利点

Advantage of Using an Ultrasonically Activated Scalpel (Harmonic Scalpel) for Laparoscopic Adrenalectomy and Nephrectomy

　腹腔鏡下副腎摘除術は，その開始時より広く受け入れられているが，手術時間を短縮し合併症を減らすのに高度な技術を要する．ハーモニック・スカルペルは煙を出さず，組織の侵襲が少なく，術者と患者双方にとって安全であり，剥離を容易にする器具である．腎・副腎摘除術の手技を習得する段階にある医師にとって，ハーモニック・スカルペルは手術を容易にする器具である．

Since laparoscopic techniques were first applied to adrenal surgery, it has been widely accepted. However laparoscopic adrenalectomy requires a high degree of technical skill and experience to reduce surgical duration and avoid complications. Development of an ultrasonically activated scalpel and its use in laparo-scopic surgery was reported by Amaral in 1994. We recently performed laparoscopic adrenalectomy using this device. The results were satisfactory because this device does not create smoke, causes minimal tissue injury, is safe for the surgeon and patient, and facilitates dissection.