形成外科における内視鏡補助下手術の工夫

Endoscopic surgery in plastic and reconstructive surgery

◆要旨：当科では，2003年4月～2008年6月までの19例の患者に対して内視鏡補助下に手術を施行した．その内訳は，皮下腫瘤の摘出が11例，顔面神経麻痺の眉毛つり上げが1例，ティッシュ・エキスパンダーの留置が2例，眼窩底骨折の整復が2例，皮弁の挙上が1例，褥瘡の手術が2であった．形成外科で内視鏡下手術を行うには，手術器具の工夫，操作腔の保持のための工夫が必要であった．

　また，19例中9例と使用機会の多かった前額部皮下腫瘤について手術時間を中心に検討した．

　形成外科における，内視鏡補助下手術の普及は十分とはいえないが，瘢痕を最小限にできる点で整容的な手術が多い形成外科にとっては利点が多く，さらなる工夫，検討を重ねていきたい．

　Nineteen patients have been operated using endoscope in our department since April 2003 to June 2008. Among the 19 patients, the following disorders were observed : 11 subcutaneous tumor,

　2 insertion of tissue expander, 2 reconstruction of blowout fracture 1 eyebrow lift for the treatment of facial paralysis, 1 elevation of trapezius musclocutaneous flap and 1 fistula of a pressure ulcer.

　When performing endoscopic procedue in plastic surgery, surgical devices have to be cogitated and obtaining the working space has to be planned well..

　The extraction of the subcutaneous tumors, the most common disorder in our study, was reviewed in more detail, especially focusing on the operative time.

　Although endoscopic surgery has not fully spread in the field of plastic surgery, the advantages, especially cosmetic results, are enormous. Further study should be eoncouraged.