後腹膜粘液性囊胞腺腫に対しS.A.N.D.バルーンカテーテルが有用であった後腹膜鏡下腫瘍摘出術の1例

A case of retroperitoneal mucinous cystadenoma easily resected laparoscopically using the S.A.N.D. balloon catheter

◆要旨：患者は38歳，女性．下腹部痛で近医を受診し，超音波検査で左下腹部囊胞性病変を指摘された．症状は自然消失したが，精査目的に当院を紹介された．CT，MRIで17×10×5cmの均一な薄い被膜を有する単房性病変を認め，周辺臓器との連続性はみられなかった．後腹膜リンパ管腫と術前診断し，後腹膜鏡下腫瘍摘出術を施行した．右側臥位，ジャックナイフ位，4ポート，送気法で施行した．S.A.N.D.バルーンカテーテルは，腫瘍の内容液を吸引して虚脱させ，腫瘍の牽引にも有効だった．虚脱した腫瘍はポート孔より摘出可能だった．病理組織学的には粘液性囊胞腺腫で良性だった．良性囊胞性腫瘍に対する内視鏡下腫瘍摘出術でS.A.N.D.バルーンカテーテルは手技を容易にする有用なデバイスである．

　A 38-year-old female underwent a medical examination for intermittent lower abdominal pain. Abdominal ultrasonography described a cystic tumor in the left lower abdomen. Abdominal CT and MRI demonstrated a 17×10×5 cm monocystic tumor with a thin homogeneous capsule independent to surrounding other organs. Under the preoperative diagnosis of retroperitoneal lymphangioma, laparoscopic resection of the tumor was performed in the right lateral and jack knife position with four ports. The S.A.N.D. balloon catheter worked effectively in the procedure, such as suctioning the content, retracting, and removing the tumor without leakage of the content. Pathological diagnosis was benign mucinous cystadenoma. We concluded that the S.A.N.D. balloon catheter was a useful device for laparoscopic operation of benign cystic tumor.