簡単かつ迅速な内視鏡下体内結紮法

A simplified and quick technique for intracorporeal knot tying

◆要旨：より簡便かつ迅速な内視鏡下体内結紮法を考案したので報告する．本法は外科基本手技である片手結びと糸の動きはほぼ同じである．運針後，左鉗子で針側の糸を体外に引き出す（stay tail）．Short tailを左鉗子で把持し，手前よりstay tailと交差させ，その間に右持針器を挿入する．Short tailを左鉗子から右持針器に持ち替え，ループから引き抜く．引き抜いた糸は左方に，stay tailは右方に締めることで第一結紮が終了する．第二結紮は第一結紮と左右を逆に行う．本法は，片方の糸がstay tailとなり把持する必要がないため，2本の鉗子で簡単かつ迅速にループを作ることが可能である．

　We devised a simplified and quick technique for intracorporeal knot tying.

The suture, after passing through the tissue, is taken out with the needle from the body using the left grasper（stay tail）. The short tail and the stay tail are crossed using the left grasper and the right needle driver is inserted between the two sutures. The short tail is held by the right needle driver and pulled out through a loop. The short tail is pulled to the left and the stay tail is pulled to the right, thus finishing the primary knot tying. The second knot tying is done by reversing the right and the left. In this method, because one suture is fixed, a loop can be made simply and quickly by using two graspers.