単孔式腹腔鏡下手術におけるアクセス用器具の開発

Development of an access instrument for single-incision laparoscopic surgery

◆要旨：現在，単孔式腹腔鏡下手術が急速に広まっているが，アクセス方法や手術機器同士の干渉などの問題の解決のために手技のみならずデバイスの検討・研究がなされている．今回，筆者らは単孔式腹腔鏡下手術のアクセス用器具を開発したので紹介する．本開発品は既存の切開創縁保護器具に装着するシリコ－ン製のキャップで，そのキャップの面版から複数本のトロッカーを随意に腹腔内に挿入することで単孔式腹腔鏡下手術を可能とする．臨床応用でも安全かつ簡便に取り扱いができ，手術機器操作の可動制限を軽減できた．本開発品は，経済的な単孔式腹腔鏡下手術のアクセス用器具となり得ると考えた．

　Today, single-incision laparoscopic surgery is rapidly spreading, and evaluation and research of not only the procedure but also devices are being conducted to overcome problems regarding the access method and interference between surgical instruments. In this report, a new access instrument for single-incision laparoscopic surgery that we developed is presented. The instrument, a silicone cap designed to be applied to an existing incision margin protector, allows insertion of multiple trocars freely into the abdominal cavity through it, allowing single-incision laparoscopic surgery. On clinical application, it could be handled safely and easily. It could also mitigate the restriction of movements for surgical instruments. This instrument is expected to be useful as an access device for more economic single-incision laparoscopic surgery.